Opioid Use Decreases With Electrotherapy, Acupuncture After Knee Replacement

Electrotherapy and acupuncture were associated with reduced or delayed opioid use following total knee arthroplasty, according to a recent meta-analysis.

To analyze pharmacologic vs nonpharmacologic therapies plus standard care for post-surgery pain, the researchers searched numerous online databases for clinical trials occurring between January 1946 and April 2016. The researchers analyzed the data of 2391 patients from 39 trials. Postoperative pain and the consumption of opioids and analgesics were assessed as the main outcomes.
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The researchers found that continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture were the most commonly performed interventions.

Moderate-certainty evidence showed that electrotherapy had reduced the use of opioids and that acupuncture had delayed opioid use. However, low-certainty evidence found that acupuncture had improved pain.

While very low-certainty evidence showed that cryotherapy had reduced opioid use and improved pain, low-certainty and very low-certainty evidence found that continuous passive motion and preoperative exercise did not improve pain or reduce opioid consumption.

“In this meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption,” the researchers concluded.

—Melissa Weiss

Reference:

Tedesco D, Gori D, Desai KR, et al. Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis [published online August 16, 2017]. JAMA Surg. doi:10.1001/jamasurg.2017.2872.