Opioid-free Total Hip Arthroplasty

Not Applicable

Withdrawn

• Conditions: Hip Osteoarthritis
• Interventions: Other: Exclusion of opioid analgesics

• Registration Number: NCT04421196
• Lead Sponsor: Johns Hopkins University

Brief Summary

The primary objective of investigators' proposed study is to demonstrate that the following two cohorts undergoing total hip arthroplasty will have equivalent visual analog scale (VAS) scores up to 3 months post-operatively: one that is administered a modified multimodal analgesic pathway without opioids and the other administered the current standard multimodal analgesic pathway used at Johns Hopkins Bayview Hospital (which includes opioids). The secondary objective is to demonstrate that these cohorts will also have equivalent functional outcomes as determined by both objective measures (such as hip range of motion) and patient-reported outcome measures, such as the Hip Disability and Osteoarthritis Outcome Score (HOOS) and the University of California at Los Angeles (UCLA) activity score.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-05-19
• Study First Submitted QC: 2020-06-04
• Study First Posted: 2020-06-09
• Status Verified: 2022-04
• Study Start: 2022-09-15
• Last Update Submitted: 2022-09-19
• Last Update Posted: 2022-09-21
• Primary Completion: 2023-09-01
• Study Completion: 2023-12-01

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: Not specified

Inclusion Criteria

• Patients of all ages with end-stage primary hip osteoarthritis.

Exclusion Criteria

• Patients with creatinine clearance between 30 and 60 mL/min
• Use of any opioid analgesics in the 6 months preceding surgery
• Revision total hip arthroplasty
• Patients with liver insufficiency
• Patients on chronic anticoagulation
• Workers compensation patients
• Patients who cannot receive Acetaminophen, Ketorolac, Celecoxib, or Gabapentin for any reason (e.g. allergies)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Modified multimodal analgesic pathway without opioids	Exclusion of opioid analgesics	This is the experimental group, who will receive a modified multimodal analgesic regimen, which excludes the use of any opioids. The modified multimodal analgesic regimen utilizes the following medications: includes the following medications: Gabapentin 300 mg, Celecoxib 200 mg (Meloxicam if sulfa), Non-opioid anesthetics (fluranes, propofol, ketamine, etc.); Periarticular injection: Liposomal bupivacaine, 0.25 % bupivacaine with epinephrine, Betamethasone sodium phosphate, betamethasone acetate and Ketorolac IV; high volume cryotherapy, Ketorolac 30 mg IV, Ketamine IV, Ketorolac 15 mg PO, Acetaminophen 1000 mg PO q6hr

Primary Outcome Measures

Name	Time	Method
Change in post-operative pain assessed by the Visual analog scale (VAS) pain scores	From immediate post-operative period to 3 months post-operatively	Post-operative pain scores ranging from 0 to 10; 0 being no pain and 10 being the worst pain ever felt

Secondary Outcome Measures

Name	Time	Method
Change in pain satisfaction as assessed by Hip Disability and Osteoarthritis Outcome Score (HOOS)	From pre-operative clinic visit to immediate post-operative period, then to 3 months post-operatively	A patient-reported measure that assesses components such as assesses patient pain, satisfaction including stiffness and range of motion, activity limitations-daily living, sports and recreation function, and quality of life. Scores range from 0 to 100 with a score of 0 indicating the worst possible hip symptoms and 100 indicating no hip symptoms.
Change in Physical Activity level as assessed by the University of California at Los Angeles (UCLA) Scale	From pre-operative clinic visit to immediate post-operative period, and then to 3 months post-operatively	The UCLA scale is a patient-reported measure ranging from 1 to 10. Patients indicate their most appropriate activity level, with 1 defined as "no physical activity, dependent on others" and 10 defined as "regular participation in impact sports."