Enhanced Recovery After Major Surgery and Chronic Pain for Total Knee Arthroplasty

Launched by HOSPITAL FOR SPECIAL SURGERY, NEW YORK · Jul 31, 2023

Keywords

ClinConnect Summary

This clinical trial is studying how different pain management techniques affect the amount of opioid medication patients use after total knee replacement surgery. Specifically, it compares two methods: one group will receive an adductor canal catheter (a small tube to help manage pain) and the other group will receive a sham catheter (which does not deliver medication). The researchers want to find out if using the actual catheter leads to less opioid use 24 to 48 hours after surgery and how it affects pain levels up to six months later.

To be eligible for this study, participants need to be between 18 and 75 years old, scheduled for knee surgery due to osteoarthritis, and able to use a smartphone. They must also be able to follow the study instructions and live within an hour of the hospital. During the trial, participants will communicate with their pain doctor through a mobile app while the catheter is in place. The goal is to gather information that could help improve pain management after knee surgery and reduce reliance on opioids.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients with osteoarthritis scheduled for a primary total knee arthroplasty with a participating surgeon
• • Age 18 to 75 years
• • Planned use of regional anesthesia
• • Ability to follow study protocol
• • English speaking (secondary outcomes include questionnaires validated in English only)
• • Patients of participating surgeons: Drs. Mayman, Jerabek, Westrich, Su, Della Valle, Alexiades
• • Lives within one hour of the hospital
• • Has a smartphone
• Exclusion Criteria:
• • Hepatic or renal insufficiency
• • Younger than 18 years old and older than 65
• • Patients undergoing general anesthesia
• • Allergy or intolerance to one of the study medications
• • BMI \> 40
• • Diabetes
• • ASA of III,IV
• • Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
• • PCS \> 30
• • Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of \>5mg/day for one month)
• • Patients with severe valgus deformity or flexion contracture
• • Patients unable to follow home catheter instructions and unwilling to go home with an infusing catheter
• • Patients who have no home caregivers in the event if a catheter is to be sent home with the patient
• • Patients with planned stay at rehab facility