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    
Abstract/OtherAbstract:
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.
Authors:
Scott S Reuben; Evan F Ekman
Related Documents :
9195439 - Arthroscopic debridement alone for intercarpal ligament tears.
21063679 - Arthroscopic patellar reinsertion of the mpfl in acute patellar dislocations.
17563889 - Predictors of morbidity following free flap reconstruction for cancer of the head and n...
18442689 - Comparison of clinical results according to amount of preserved remnant in arthroscopic...
19336619 - Clinical comparison of anteromedial versus anterolateral tibial tunnel direction for tr...
11337239 - Review of the clinical results of arthroscopic meniscal repair.
23075729 - Percutaneous extraction of leads from coronary sinus vein and branch by modified techni...
16636219 - Predicting medical and surgical complications of carotid endarterectomy: comparing the ...
11677999 - Postoperative morbidity and mortality after gastrectomy for gastric carcinoma.
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    
Affiliation:
Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA. scott.reuben@bhs.org
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Ambulatory Surgical Procedures* / methods
Analgesics / administration & dosage*
Anterior Cruciate Ligament / drug effects,  injuries,  surgery*
Combined Modality Therapy
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Pain, Postoperative / epidemiology,  prevention & control
Reconstructive Surgical Procedures* / methods
Recovery of Function / physiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Analgesics
Comments/Corrections
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


Previous Document:  Evaluating the analgesic efficacy of administering celecoxib as a component of multimodal analgesia ...
Next Document:  Postoperative intravenous morphine consumption, pain scores, and side effects with perioperative ora...