Document Detail

The effect of initiating a preventive multimodal analgesic regimen on long-term patient outcomes for outpatient anterior cruciate ligament reconstruction surgery.
MedLine Citation:
PMID:  17578979     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Unrelieved postoperative pain may impair rehabilitation, delay recovery, and result in poor outcomes. Preventive multimodal analgesic techniques may improve long-term outcome after surgery. METHODS: We randomized 200 consecutive patients to receive acetaminophen 1000 mg and either celecoxib 400 mg or placebo 1-2 h before anterior cruciate ligament surgery. All patients received intraarticular analgesics and had an external cooling system applied to the operative knee. After discharge patients were instructed to take acetaminophen 1000 mg every 6 h and either celecoxib 200 mg every 12 h or matching placebo for the first 14 days postoperatively. All patients were enrolled in an accelerated rehabilitation program. Six months postoperatively, the level of activity was assessed, as was the presence of patellofemoral complications including: anterior knee pain, flexion contracture, quadriceps weakness, and complex regional pain syndrome. RESULTS: More patients in the control group developed patellofemoral complications compared to the celecoxib group (P = 0.001) including anterior knee pain (14/96; 15%) vs (4/95; 1%), complex regional pain syndrome (7/96; 7%) vs (1/95; 1%), flexion contractures (9/96; 9%) vs (2/95; 2%), and scar tissue requiring re-arthroscopy (8/96; 8%) vs (2/95; 2%) respectively. More patients in the celecoxib group returned to a higher activity level (84% vs 65%) (P < 0.01), were able to participate at a more intense level (P < 0.02), and return to full sports activity (P < 0.05). CONCLUSIONS: The administration of celecoxib as a component of a preventive multimodal analgesic technique for anterior cruciate ligament reconstruction reduces long-term patellofemoral complications and increases the likelihood of returning to a preinjury level of activity.
Scott S Reuben; Evan F Ekman
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Retracted Publication    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  105     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-20     Completed Date:  2007-07-19     Revised Date:  2009-04-08    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  228-32     Citation Subset:  AIM; IM    
Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA.
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MeSH Terms
Ambulatory Surgical Procedures* / methods
Analgesics / administration & dosage*
Anterior Cruciate Ligament / drug effects,  injuries,  surgery*
Combined Modality Therapy
Double-Blind Method
Follow-Up Studies
Pain, Postoperative / epidemiology,  prevention & control
Reconstructive Surgical Procedures* / methods
Recovery of Function / physiology
Treatment Outcome
Reg. No./Substance:
Comment In:
Anesth Analg. 2007 Jul;105(1):19-20   [PMID:  17578947 ]
Retraction In:
Shafer SL. Anesth Analg. 2009 Apr;108(4):1350   [PMID:  19299812 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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