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Do Drug-Free Interventions Reduce Pain or Opioid Consumption After Total Knee Arthroplasty?

Researchers find that electrotherapy and acupuncture might reduce and delay opioid consumption, but do little to control pain.

Published: August 17, 2017

PINNED DOWN Researchers found that acupuncture might reduce or delay opioid consumption, but likely does little to improve pain.

Using electrotherapy and acupuncture instead of opioids to manage post-op pain after knee replacement looks good on paper, but researchers found that most nonpharmacological interventions do little to reduce post-op pain and opioid consumption after total knee arthroplasty.

"Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty," a new study in the Journal of the American Medical Association, examined the 5 most commonly performed drug-free interventions after total knee arthroplasty: continuous passive motion, pre-operative exercise, cryotherapy, electrotherapy and acupuncture.

Of these, electrotherapy and acupuncture may be your best bets, as researchers found "moderate" evidence that they helped somewhat to reduce and delay opioid consumption. However, they did little to relieve pain.

Meanwhile, "very low-certainty evidence" showed cryotherapy may reduce opioid consumption, but doesn't appear to reduce pain, the study finds, while continuous passive motion and pre-operative exercise don't seem to help in either area.

Researchers from Stanford University examined data from 39 randomized clinical trials encompassing 2,391 patients. The evidence in favor of acupuncture and electrotherapy is moderate, they say, and the evidence for cryotherapy is "very low-certainty."

"Because surgery has been identified as an avenue for addiction, it is important to recognize effective alternatives to standard pharmacological therapy, which remains the first option for treatment," say the authors.

Jim Burger

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