NSAIDs may effectively reduce stiffness, manipulation under anesthesia after TKA

ByHunter Firment

Fact checked byMindy Valcarcel, MS

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Key takeaways:

NSAIDs may reduce manipulation under anesthesia after TKA.
For patients who cannot take anti-inflammatory drugs, corticosteroids may be an effective alternative.

SAN DIEGO — The use of NSAIDs may be an effective way to reduce postoperative stiffness and manipulation under anesthesia procedures following total knee arthroplasty, according to results presented here.

“Pharmacologic prophylaxis with anti-inflammatories seems to be an effective way to reduce the risk of stiffness and is an important part of our postoperative protocols,” Peter K. Sculco, MD, hip and knee surgeon at Hospital for Special Surgery, told Healio about results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

Sculco IG — Data were derived from Selkridge I, et al. Paper 151. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.

Sculco and colleagues retrospectively analyzed data from 23,091 patients (mean age, 65.4 years; 61% women) who underwent primary TKA from 2017 to 2021 for NSAID prescriptions within 90 days of surgery, manipulation under anesthesia procedures and patient demographics. The primary outcome measured was manipulation under anesthesia within 90 days of TKA.

Peter K. Sculco

In terms of findings, Sculco said patients who had postoperative NSAID prescriptions had a significantly decreased risk for manipulation under anesthesia (4.5%) vs. patients who were unable to take NSAIDs for various reasons (12.6%).

Sculco said further research on alternatives for patients who are unable to take NSAIDs is necessary to combat the increased risk for developing postoperative stiffness requiring manipulation under anesthesia.

“For patients who cannot take anti-inflammatories, we have to think of alternatives — potentially the use of corticosteroids in those patients who have allergies or kidney issues,” Sculco said. “Corticosteroids are safe to take after surgery and that has been demonstrated, but further work is needed to see the impact of corticosteroids and whether it can reduce the risk of manipulation to the level of the patients who were able to take anti-inflammatories.”

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Sources/Disclosures

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Source:

Selkridge I, et al. Paper 151. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.

Disclosures: Sculco reports no relevant financial disclosures.