Preoperative meloxicam versus postoperative meloxicam for pain control, patients’ satisfaction and function recovery in hip osteoarthritis patients who receive total hip arthroplasty: a randomized, controlled study

Abstract

This study aimed to compare the analgesic effect, patients' satisfaction, tolerance and hip-joint function recovery by preoperative meloxicam versus postoperative meloxicam in treating hip osteoarthritis (OA) patients receiving total hip arthroplasty (THA). 132 hip OA patients who underwent THA surgery were allocated into postoperative analgesia (POST) and preoperative analgesia (PRE) groups at a 1:1 ratio. In the PRE group, patients took meloxicam 15 mg at 24 h pre-operation, 7.5 mg at 4 h, 24 h, 48 h and 72 h post-operation; in the POST group, patients received meloxicam 15 mg at 4 h post-operation, then 7.5 mg at 24 h, 48 h and 72 h post-operation. Furthermore, postoperative pain, consumption of patient-controlled analgesia (PCA), overall satisfaction and adverse events were evaluated within 96 h post-operation; meanwhile, Harris hip score was assessed within 6 months post-operation. Pain VAS at rest at 6 h, 12 h, 24 h, and pain VAS at passive movement at 6 h, 12 h were decreased in PRE group compared to POST group. In addition, additional consumption of PCA and the total consumption of PCA were both reduced in PRE group compared to POST group. Additionally, overall satisfaction in PRE group was higher at 24 h, 48 h and 72 h compared to POST group. While Harris hip score was of no difference between POST group and PRE group at M3 or M6. Besides, no difference in adverse events incidence was found between the two groups. In conclusion, preoperative meloxicam achieves better efficacy and similar tolerance compared to postoperative meloxicam in hip OA patients post THA.

Evaluation of analgesic effect, joint function recovery and safety of meloxicam in knee osteoarthritis patients who receive total knee arthroplasty

“…This result was consistent with the studies that focus on the application of meloxicam in other joint surgeries. [ 7 , 14 ] In addition, these data also implied that meloxicam might be a safe antalgic in knee OA patients after TKA.…”

“…[ 10 ] It has also been exhibited that meloxicam is able to control postoperative pain in total hip arthroplasty. [ 7 ] In terms of TKA, the postoperative analgesic effect of meloxicam is not clear. In this study, we discovered that meloxicam was able to reduce short-term pain in knee OA patients after TKA.…”

“…Regarding the effect of meloxicam on postoperative recovery, a previous study illustrates that meloxicam does not affect Harris hip score in patients receiving total hip arthroplasty within 6 months. [ 7 ] Furthermore, another study also reveals that meloxicam does not affect knee range of motion, International Knee Documentation Committee score and Lysholm score in patients who underwent arthroscopic knee surgery. [ 9 ] In our study, we discovered that meloxicam did not affect long-term knee function recovery which assessed by HSS score in knee OA patients who received TKA either, a possible explanation could be that meloxicam was not the main factor that affected the knee function recovery in patients receiving TKA but other factors including the skill of the surgeons and success of TKA were.…”

“…[ 6 ] Among the NSAIDs, meloxicam is a selective inhibitor of cyclooxygenase-2 that can ease the pain following total hip arthroplasty. [ 7 , 8 ] Moreover, according to a previous study, meloxicam is able to moderate the pain after arthroscopic knee surgery. [ 9 ] Based on the above-mentioned information, we hypothesized that meloxicam might decrease the pain in knee OA patients after TKA.…”

“…Meanwhile, a previous study reveals that NSAIDs have the capability of pain-relieving in arthral surgeries such as arthroscopic rotator cuff surgery [6] . Among the NSAIDs, meloxicam is a selective inhibitor of cyclooxygenase-2 that can ease the pain following total hip arthroplasty [7,8] . Moreover, according to a previous study, meloxicam is able to moderate the pain after arthroscopic knee surgery [9] .…”