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Pain benefits seen from COX-2 selective NSAID use extended through 6 weeks after knee replacement

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Patients who underwent total knee replacement and took a 400 mg cyclooxygenase-2 selective NSAID daily for 6 weeks following their discharge from the hospital had significantly better recovery than those who took a placebo, based on results of a double-blind study.

All of the 107 patients in the study received 400 mg of celecoxib (a cyclooxygenase-2 [COX-2] selective NSAID) prior to primary total knee replacement and were randomized into a study or placebo group at the time of hospital discharge.

The study’s primary endpoint was narcotic use at 3, 6, 12 and 24 weeks and 1 year postoperatively. Secondary endpoints included Visual Analog Scale pain scores taken at rest/activity and at night, knee range of motion, Knee Society Scores, the Oxford Knee Score and SF-12 physical and mental composite scores.

“Narcotic use was significantly less in our study group,” William C. Schroer, MD, said at the Knee Society Specialty Day Meeting held during the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.

The investigators also discovered that the pain scores and knee outcome measures for the study group significantly improved through the 12-month follow-up.

Compared with the placebo group, the study group turned in better knee flexion scores for the first postoperative year, Schroer said.

Schroer, who performed all the surgeries, noted that 97% of all the necessary data was collected in both groups, and the group demographics were similar. “This study demonstrates a significant improvement in continuing celecoxib for 6 weeks after surgery,” particularly as part of a multimodal pain management strategy, he concluded.

Reference:

• Schroer WC, Diesfeld PJ, LeMarr AR, Reedy ME. Six-week postoperative Cox-2 inhibitor use improves TKA recovery: A double-blind, placebo-controlled study. Presented at the Knee Society Specialty Day Meeting. Feb. 19, 2011. San Diego.

Disclosure: The study was funded by a grant from Pfizer.

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