Comparison of transdermal and oral anti-inflammatory drugs on immediate post-operative pain control in total knee arthroplasty: a randomized controlled trial.

Study Summary

100 patients undergoing primary unilateral total knee arthroplasty (TKA) for knee osteoarthritis were randomized to receive a transdermal 40 mg Esflurbiprofen patch or oral Celecoxib 200 mg once daily for 14 days as part of a standardized multimodal analgesic regimen. The primary outcome of interest was pain intensity measured using the visual analogue scale (VAS) at rest and during movement on post-operative day (POD) 14. Secondary outcomes included VAS at 6 weeks, timed up-and-go test (TUGT), 5-time sit-to-stand test (5TSST), 3-minute walk test (3MWT), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), glomerular filtration rate (GFR), and adverse events. Outcomes were assessed through 6 weeks. Overall, the results of the study revealed that transdermal Esflurbiprofen was non-inferior to oral Celecoxib for pain at rest and during movement at POD 14, with comparable functional recovery and safety. These findings suggested that transdermal Esflurbiprofen represented a feasible alternative to oral Celecoxib following TKA, particularly when systemic nonsteroidal anti-inflammatory drug (NSAID) exposure was undesirable.