When orthopedic surgeon Andrew Wickline stood up in a conference of the American Association of Hip and Knee Surgeons in 2013 and declared that doctors like them needed to stop “hurting people” by prescribing large numbers of oxycodone pills to relieve post-op pain, there was widespread laughter and a rebuke from the lectern.

Come back when you’ve published something, the man running the meeting told Wickline.

Since then, the West Virginia native, who practices in New Hartford, N.Y., has done research using journals kept by his own patients that supports a protocol he’s promoting, under which patients recover with the help of fewer than 10 oxycodone pills — at least 100 fewer than the current average.

Wickline was in Altoona on Wednesday with local orthopedic surgeon and program champion Christopher McClellan calling attention to the “March 2 A Million Opioid-Free Joint Surgery Campaign,” which would replace the typical aggressive post-op physical therapy regimen with a self-managed protocol using frequent joint flexing that induces far less pain, even as it reintroduces flexibility — thus requiring far fewer pain pills, according to Wickline and McClellan, who spoke to reporters at University Orthopedics Center, where McClellan works.

The current typical post-op regimen involves physical therapists forcing newly replaced joints three times a week into “torturous” angles, causing pain and swelling that necessitates opioid use, followed by more of the same a few days later, accompanied by more swelling and pain and more pills, according to the doctors.

The typical regiment is “go, go, go,” in hopes of ensuring maximum ultimate flexibility, they said.

The Wickline protocol involves hourly mild flexing for several minutes, followed by ice and elevation for 40 minutes — activities that never generate the level of pain and swelling that the normal protocol causes, even as they return patients to the desired range of motion faster, they said.

In doing things by small stages, “it’s like training a puppy,” Wickline said.

Getting back to normal levels of activity shouldn’t be “a race” anyway, McClellan said.

Wickline showed a chart that compared the post-op swelling that patients at a well-known Colorado orthopedic center experienced versus the much lower swelling that patients experienced using his protocol.

In seven years, 95% of his 5,600 patients have needed 10 or fewer oxycodone pills, Wickline said.

Wickline and McClellan are actually trying to get to zero opioid painkillers post-surgery with the help of a non-addictive, non-opioid painkiller that shuts off about 80% of the pain connection between knee and brain, the doctors said.

The regimen is 30 pills every 12 hours for two weeks.

The current cost is $15 per pill, with a coupon that makes it cheaper.

Insurance doesn’t cover the medication yet, which is unfortunate and doesn’t make sense, McClellan said.

In addition to being non-addictive, this medication doesn’t cause vomiting or constipation or hallucinations — although it requires healthy kidney function and can cause rashes and itching, the doctors said.

They expect that only 1% to 3% of joint replacement patients who use this new medication in tandem with the flexing protocol will need opioids to deal with their post-op.

But convincing the vast majority of joint surgeons to reduce their opioid prescribing habits is an “incremental” process, they said.

Wickline isn’t profiting by his campaign, he said.

“I’m losing money,” he said.

He’s pursuing it because his conscience was bothered by the inevitable addictions and overdoses his prescribing of opioids was causing to his post-op patients, judging by the statistics that apply, he said.

“I’ve done 20,000 surgeries,” Wickline said. “I’m personally responsible for 340 overdoses.”

There is a 6% chance of addiction when using opioids around the clock for 24 hours and a 20% chance of addiction when using opioids 10 days in a row, Wickline said.

To encourage adoption of his protocol, Wickline has created a “leaderboard” on his website for doctors whose patients have used it.

McClellan is high on that leaderboard, the local doctor said.

Five years after the laughter and rebuke that followed his 2013 declaration at the AAHKS meeting, Wickline addressed an AAHKS symposium that had drawn a standing room-only crowd.

It led to more than 100 complimentary emails, he said.

Mirror Staff Writer William Kibler is at 814-949-7038.