Objective:

To compare the efficacy of a transdermal esflurbiprofen patch with oral celecoxib for post-operative pain control in total knee arthroplasty patients.

Approach:

• Study Design: A single-center, prospective, randomized controlled noninferiority trial involving 100 patients aged 50 years or older undergoing primary unilateral total knee arthroplasty.
• Intervention: Participants were randomly assigned to receive either a 40 mg transdermal esflurbiprofen patch or oral celecoxib 200 mg for 14 days, starting on postoperative day 1.
• Pain Management: All patients received a multimodal pain management regimen including paracetamol, pregabalin, a continuous adductor canal block, and infiltration between the popliteal artery and posterior capsule.
• Primary Endpoint: Pain intensity on postoperative day 14, measured by the visual analog scale.

Key Findings:

• Pain scores improved significantly from baseline in both groups throughout follow-up.
• Average pain scores at rest were 1.0 in the transdermal group and 0.8 in the oral celecoxib group by postoperative day 14.
• Average pain scores with movement were 2.5 in the transdermal group and 2.3 in the oral celecoxib group by postoperative day 14.
• No patients in either group required rescue morphine.
• Recovery of physical function was similar in both groups, with no significant differences in mobility and strength tests.
• Safety outcomes were comparable, with no serious adverse events reported.

Interpretation:

Limitations:

• Open-label design may introduce bias.
• Small sample size limits generalizability.
• Short 14-day treatment period may not capture long-term side effects.

Conclusion:

Sources:

• Arthroplasty