# Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis

## TL;DR

Celecoxib reduces the need for additional pain medication after total knee replacement surgery, according to a meta-analysis of clinical trials.

## Contribution

This study provides new evidence that celecoxib alone decreases rescue analgesic use compared to placebo after total knee arthroplasty.

## Key findings

- Patients receiving celecoxib had significantly lower rescue analgesic intake compared to those receiving a placebo.
- The meta-analysis found a mean difference of −6.89 in rescue analgesic consumption in favor of celecoxib.
- Two out of five studies showed favorable outcomes for celecoxib compared to placebo.

## Abstract

This systematic review and meta-analysis aimed to evaluate the analgesic efficacy and adverse effects of celecoxib after total knee arthroplasty. Keywords in the PubMed and Scopus databases were used to find article abstracts. Each included clinical trial was assessed using the Cochrane Collaboration risk of bias tool, and we extracted data on postoperative pain assessment using the Visual Analogue Scale (VAS) at rest, ambulation, and active range of motion, rescue analgesic intake, and adverse effects. Inverse variance tests with mean differences were used to analyze the numerical variables. The Mantel–Haenszel statistical method and the odds ratio were used to evaluate the dichotomous data. According to this qualitative assessment (n = 482), two studies presented conclusions in favor of celecoxib (n = 187), one showed similar results between celecoxib and the placebo (n = 44), and three clinical trials did not draw conclusions as to the effectiveness of celecoxib versus the placebo (n = 251). Moreover, the evaluation of the rescue analgesic intake showed that the patients receiving celecoxib had a lower intake compared to patients receiving a placebo (n = 278, I2 = 82%, p = 0.006, mean difference = −6.89, 95% IC = −11.76 to −2.02). In conclusion, the pooled analysis shows that administration of celecoxib alone results in a decrease in rescue analgesic consumption compared to a placebo after total knee surgery.