ZYNRELEF for Pain Management in Total Knee Arthroplasty

Phase 4RecruitingNCT05644496

Baptist Health South Florida242 enrolled

Overview

The goal of this randomized controlled trial is to compare opioid medication consumption after surgery for patients who have a total knee replacement. The main questions it aims to answer are: * How well does the study drug control pain in the days after surgery? * Does the study drug reduce the amount of opioid analgesic consumed after surgery? Participants in the study group will undergo a total knee replacement as planned with their surgeon. In addition, be given the study drug, Zynrelef (combination of bupivacaine and meloxicam). Researchers will compare the above to a control group who will have a total knee replace only according to usual standards to see if there are any differences in the amount of a type of pain medication (opioid analgesic) consumed in the days following surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

242

Conditions

Post Operative Pain Osteoarthritis, Knee

Interventions

Eligibility

Sex: ALLMin age: 35 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Adult patients undergoing primary unilateral total knee arthroplasty \[Current Procedural Terminology Code: 27447\] 2. Patients with a diagnosis of primary osteoarthritis \[ICD-10 codes: M17.0, M17.10, M17.11, M17.12\] 3. Varus deformity less than 10 degrees 4. Flexion contracture less than 10 degrees 5. Age 35 - 70 years old 6. BMI \< 40 7. Patients who are discharged on the same day after the unilateral total knee arthroplasty procedure Exclusion Criteria: 1. Inflammatory arthritis 2. Post-traumatic arthritis 3. Valgus deformity 4. Severe varus (\> 10 degrees) 5. Severe flexion contracture (\> 10 degrees) 6. Overnight or longer hospital stay after surgery 7. Prior surgery on affected knee other than knee arthroscopy for meniscal or cartilage debridement/repair 8. Creatinine \> 1.2 9. Chronic Kidney Disease (CKD) stage 3, 4, 5 or end stage renal disease 10. Uncontrolled Diabetes mellitus (Glycated Hemoglobin \> 8.0%) 11. Current liver disease 12. Personal history of depression or anxiety disorder 13. Personal history of Deep Venous Thrombosis (DVT) or Pulmonary Embolism (PE) 14. Narcotic or tramadol use within 2 weeks of the planned procedure 15. Allergy to aspirin, NSAIDS, oxycodone, Tylenol, local anesthetics 16. Walking aid for anything other than the operative joint 17. Contraindication for use of the study drug (as specified by the manufacturer): * Known hypersensitivity to local amide anesthetics, NSAIDs or study drug components * History of asthma, urticaria or other allergic-type reactions to aspirin or other NSAIDs 18. Patients taking the following medications: * Amitriptyline * Nortriptyline * Gabapentin * Pregabalin * Duloxetine (SNRI) * Des-Venlafaxine (SNRI) * Cyclobenzaprine * Baclofen 19. Pregnant or lactating females 20. Patients unable to provide informed consent 21. Subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures

Outcomes

Primary Outcomes

Total opioid analgesic consumption

Amount of opioid analgesic consumed in the time frame calculated as Morphine Milligram Equivalent (MME).

Time frame: 5 days following surgical procedure

Change in pain assessment scores

Pain assessment scores using the pain Numeric Rating Scale for pain (NRS). The NRS scale is measured on a scale of 0 - 10, where 0 is no pain and 10 is the most severe pain.

Time frame: Baseline and every 24 hours for 120 hours following surgical procedure

Secondary Outcomes

Incidence of major complications

Number of procedure-related adverse events and medication-related adverse events.

Time frame: 42 days following surgical procedure