The goal of this prospective, randomized study is to compare the outcomes of two cohorts of patients undergoing primary Total Knee Arthroplasty (TKA) and to determine whether a single dose of methadone administered preoperatively is effective at reducing postoperative opioid usage and postoperative pain versus a control group of patients receiving standard intraoperative opioids only for primary TKA. The main questions it aims to answer are: * What is the efficacy of a single preoperative dose of methadone in reducing opioid consumption and postoperative pain in primary total knee arthroplasty? * Will the study results demonstrate the effectiveness and safety of a single preoperative dose of methadone (10 mg) in primary total knee arthroplasty in reducing postoperative opioid usage while maintaining a similar or better level of pain control when compared to a standard pain control regimen? Researchers will compare Methadone to a standard pain control regimen (Oxycodone) to see if Methadone is equivalent or more effective at reducing opioid consumption and postoperative pain in primary total knee arthroplasty Participants will: * be randomized into one of two groups * undergo a primary TKA * complete a tracking sheet documenting daily pain medicine usage and VAS pain level for the first 14 days following the TKA * return to office at 2 weeks and 6 weeks postop for follow-up * complete additional questionnaires at 2 weeks and 6 weeks postop
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
150
patient receives a one-time preoperative dose of 10 mg of methadone
patient receives a one-time preoperative dose of 10 mg of oral oxycodone
UofL Health
Louisville, Kentucky, United States
Daily Opioid Use
Daily Opioid Use as measured in MME recorded daily for the first two weeks following TKA
Time frame: 2 weeks
Total opioid usage over two weeks
total daily opioid usage (as measured in MME) during the first 14 days following TKA
Time frame: 2 weeks
Visual Analogue Scale pain score
Visual Analogue Scale knee pain score (minimum value: 0, maximum value: 10). Higher scores equate to a worse outcome (a score of zero = pain free).
Time frame: 2 weeks
Hospital Length of Stay
Number of days patient was an inpatient in the hospital prior to discharge date
Time frame: Up to 2 weeks
Discharge location
Whether patient was discharged to home or to a rehab facility
Time frame: 2 weeks
Two and six-week narcotic refill
Whether patient was prescribed a two week and/or six-week postoperative narcotic refill
Time frame: 6 weeks
Knee Injury and Osteoarthritis Outcome Score, Joint Replacement score
The Knee Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS, JR.) is a survey measuring overall knee health for individuals post total knee arthroplasty (TKA) by evaluating stiffness, pain, function, and activities of daily living. The minimum value is 0, the maximum value is 100. A higher score means a better outcome.
Time frame: preoperatively and 6 weeks (± 2 weeks) postoperatively
ROM
active range-of-motion (ROM) as measured in degrees of extension and degrees of flexion
Time frame: preoperatively, 2 weeks and 6 weeks (± 2 weeks) postoperatively
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