Designed and created by Guideline Central in participation with the American Association of Hip and Knee Surgeons
Nonsteroidal Anti-Inflammatory Drugs in Total Joint Arthroplasty
Patient Guideline Summary
Publication Date: March 1, 2020
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society about nonsteroidal anti-inflammatory drugs in total joint arthroplasty. It is limited to adults 18 years of age and older and should not be used as a reference for children.
- We will use the abbreviation NSAIDs throughout this summary to refer to nonsteroidal anti-inflammatory drugs.
- NSAIDs are a class of pain relievers that includes aspirin, naproxen, and ibuprofen.
- This patient summary focuses on the use of NSAIDs to relieve pain from joint surgery and reduce opioid use.
- An oral NSAID preoperatively reduces pain and opioid consumption better than in the early postoperative period.
- Administration of an oral selective COX-2 NSAID (meloxicam or celecoxib), as part of a multimodal pain regimen after discharge, reduces pain and opioid consumption after surgery.
- IV ketorolac preoperatively, intraoperatively, or within 24 hours postoperatively reduces pain and opioid consumption postoperatively.
- NSAIDs administered preoperatively, intraoperatively, or postoperatively do not appear to increase the risk of medical complications following surgery.
- However, providers should consider patient comorbidities, the type of NSAID administered, dose, and duration of administration.
- NSAID: Non-steroidal Anti-inflammatory Drug
- NSAIDs: Non-Steroidal Anti-Inflammatory Drugs
Fillingham YA, Hannon CP, Roberts KC; AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup, Hamilton WG, Della Valle CJ. Nonsteroidal Anti-Inflammatory Drugs in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty. 2020 Oct;35(10):2704-2708. doi: 10.1016/j.arth.2020.05.043. Epub 2020 May 29. PMID: 32571593.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.