Perioperative administration of selective cyclooxygenase-2 inhibitors for postoperative pain management in patients after total knee arthroplasty

8 studies (571 patients) were analyzed to evaluate the postoperative effects of selective cyclooxygenase-2 (COX-2) inhibitors when administered to patients during TKA. Results indicated that COX-2 inhibitors administered during TKA resulted in reduced postoperative pain, opioid consumption, and incidence of complications. Blood loss during the first 24 hours following surgery did not differ between patients who received COX-2 inhibitors compared to a control. It should be noted that selective COX-2 inhibitors have been associated with an increased risk of myocardial infarction and rofecoxib, a drug used in three of the included studies has been removed from the market.