The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Effects of celecoxib on early recovery after total knee arthroplasty

Author : KE Yan, LIU Qiang, WANG Kai, LIN Jian-hao.     
Working unit : Department of Orthopedics, Peking University People's Hospital, Beijing 100044, China
Page : 923-928.
Key words : celecoxib, total knee arthroplasty (TKA) , pain, early stage after operation, prospective study
Abstract: [Objective] To explore the effects of celecoxib on early recovery, including pain, inflammatory reaction, functional restoration and patient satisfaction after total knee arthroplasty (TKA) . [Methods] A total of 80 patients who were candidates of unilateral TKA were enrolled into this prospective study and randomly divided into the celecoxib group, in which the patients received celecoxib in the perioperative period, and the blank control groups. In addition, all the patient in both groups were given controlled intravenous analgesia for 48 h after TKA. The VAS for pain, the bilateral difference of leg circumference and bilateral difference of skin temperature were used as parameters of early postoperative reaction, additionally, the KSS,WOMAC, SF-12 scores and CASI self-satisfaction were used for evaluation of the early clinical consequences, moreover, the cytokines in both peripheral blood and synovial fluid were detected. [Results] The celecoxib group proved significantly less VAS score, bilateral difference of leg circumference and bilateral difference of skin temperature than the control group during the early stage after operation (P<0.05) . The KSS score significantly increased over time after operation in both groups (P<0.05) . The celecoxib group was significantly superior to the control group in KSS, WOMAC and SF-12 physical scores (P<0.05) , In addition, the former was also significantly superior to the latter in CASI self-satisfaction at 2 weeks postoperatively (P<0.05) , nevertheless it became statistically insignificant at 6 weeks between the two groups (P>0.05) . The C- reactive protein significantly raised in both groups after operation to the peak at 48 hours and then decreased to the preoperative levels at 6 weeks, which in the celecoxib groups proved significantly lower than the control group at 24, 48 hours and 2 weeks after operation (P<0.05) . The LI-6 and IL-8 in peripheral blood were significantly lower than those in the synovial fluids, about 1/10-40 of the synovial fluid.Both the IL-6 and IL-8 in the synovial fluids in the celecoxib group were proved significantly lower than those in the control group (P<0.05) . [Conclusion] The celecoxib, a selective COX- 2 inhibitor, used perioperatively not only decreases the level of inflammatory reaction and alleviates postoperative pain, but also improves the function recovery and patient satisfaction, therefore facilitate to the early-stage rehabilitation after TKA.
summary:
Effects of celecoxib on early recovery after total knee arthroplasty   
KE Yan, LIU Qiang, WANG Kai, LIN Jian-hao.
Orthop J Chin, 28(11):   923-928.