Combined Anesthesia Linked to Better ACL Reconstruction Outcomes

Study finds lower revision rates, less pain, and reduced opioid use with combined regional and general anesthesia approach

Published on Feb. 24, 2026

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A recent study analyzing data from over 63,000 adults who underwent anterior cruciate ligament reconstruction (ACLr) found that patients receiving a combination of regional and general anesthesia experienced better long-term outcomes, including lower rates of revision surgery, reduced opioid dependence, and less persistent pain compared to those who received either technique alone.

Why it matters

ACL injuries are common, and the number of ACLr procedures has been increasing. The choice of anesthetic technique can significantly impact patient recovery and long-term outcomes. This study provides evidence that a combined anesthesia approach may lead to better pain management, earlier engagement in physical therapy, and a lower risk of requiring revision surgery.

The details

The retrospective study, led by researchers at the Pennsylvania State Health Milton S. Hershey Medical Center, compared outcomes for patients who received general anesthesia, regional anesthesia, or a combination of both. In the short term, the combined anesthesia group had a lower risk of needing revision ACLr, less postoperative pain, and reduced opioid dependence. In the long term, they also experienced lower rates of revision surgery, long-term NSAID use, persistent pain, and opioid dependence compared to the other groups.

  • The study analyzed data from January 2014 to January 2024.

The players

Priti G. Dalal, MD

Lead researcher of the study, affiliated with the Pennsylvania State Health Milton S. Hershey Medical Center.

TriNetX Global Collaborative Network

The database used to identify over 63,000 adults who underwent ACL reconstruction during the study period.

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What they’re saying

“The findings suggest that prioritizing combined anesthesia, when clinically appropriate, may lead to reduced long-term pain, decreased opioid dependence, and a lower risk of requiring revision surgery following ACLr.”

— Priti G. Dalal, MD, Lead researcher (newsdirectory3.com)

What’s next

The researchers acknowledge the limitations of their retrospective database analysis and suggest that further prospective studies are needed to confirm these findings and explore the specific mechanisms by which combined anesthesia may improve ACL reconstruction outcomes.

The takeaway

This study provides evidence that a combined regional and general anesthesia approach for ACL reconstruction may lead to better long-term outcomes, including reduced revision rates, less persistent pain, and lower opioid dependence, compared to using either technique alone. These findings could help guide anesthetic decision-making and pain management strategies for patients undergoing this common orthopedic procedure.