Background/Objectives: The objective of this study was to determine whether preoperative opioid education reduces opioid consumption after spine surgery and which educational methods are the most effective. Orthopedists are the most likely to prescribe opioids among all specialists. To alleviate the prescription opioid crisis, studies have identified ways to taper narcotic dosage and use following surgery. The role of preoperative education and its varying modalities on opioid consumption following spine surgery has yet to be reported in the literature. Methods: The study group received formal education describing the use of opioids, side effects, and alternatives to pain management. Patients were to choose their preferred modality of a 2 min narrated video and two handouts to be watched and read in their individual time, attending a small class led by a physician assistant where they watched the 2 min narrated video along with reading the two handouts or receiving a one-on-one session with the treating spine surgeon. Meanwhile, the control group received standard preoperative education. Refill prescriptions were collected from patients’ electronic medical record charts at the 2-week, 1-month, 3-month, and 6-month postoperative follow-ups. The primary outcome measure was morphine equivalents (MME) of prescription opioids at six months following spine surgery. Results: At 2 weeks postoperatively, there were no statistically significant differences between patients who received any formal narcotic education and those who did not. At 1 and 3 months postoperatively, the video education group (p-value < 0.001), class education group (p-value < 0.001), and the one-on-one education group (p-value < 0.05) all had significant reductions in opioid consumption. At 6 months postoperatively, only the video education group (p-value < 0.001) and the class education group (p-value < 0.01) had significant reductions in opioid consumption. Conclusions: A two-fold approach with a video and handouts significantly decreases the prescription dosage at six months postoperatively and allows for early opioid cessation after undergoing spine surgery.

Background: Corticosteroid injections (CSIs) have demonstrated efficacy in reducing pain and improving function for patients with arthritic and inflammatory pathology in the upper extremity. However, reports remain rare regarding the association of CSIs in the hand and postoperative complications. The purpose of this study was to assess the risk of postoperative complications after small joint arthroplasty and arthrodesis in patients who received preoperative CSIs in that joint before surgery. Materials and Methods: A retrospective review was performed of patients who underwent arthrodesis or arthroplasty of the distal interphalangeal (DIP) joint, proximal interphalangeal (PIP) joint, metacarpophalangeal (MP) joint, or thumb interphalangeal (IP) joint from January 2009 to December 2023. Variables collected included patient demographics, medical history, operative details, CSI history, and complications. The relationship between patient factors, CSI history, and postoperative complications was assessed. Results: A total of 192 joints in 115 patients were included in the analysis. Seventy-two (37.5%) small joints underwent arthroplasty, while 120 (62.5%) received arthrodesis. Twenty (10.4%) small joints received CSIs before operative management, and 9 (4.7%) received CSIs within 6 months of surgery. A total of 50 (26.0%) joints experienced complications, with 3 (1.6%) joints experiencing surgical site infections and 6 (3.1%) with nonunion. Analyses did not suggest a higher risk for complications in patients who received CSIs in the hand before arthroplasty or arthrodesis. Conclusions: CSIs within 6 months of hand arthrodesis or arthroplasty did not result in significantly higher complication rates, suggesting that CSIs can be performed safely before operative management of small joint arthritis.