Opioid Reduction in Orthopaedic Surgery (OREOS) - Knees

Kim Madden

Status: Completed

Conditions: Chronic Post Operative Pain; Knee Osteoarthritis

Treatments: Other: Multicomponent opioid reduction and pain management pathway; Other: Standard care

Study type: Interventional

Funder types: Other

Identifiers

NCT04968132

OREOS-knee

Details and patient eligibility

About

Knee replacements are the second most common surgery in Canada. Most patients recover very well but research consistently shows that 1 in 5 patients still have pain many months after surgery. Doctors often prescribe opioid medications for pain after surgery (e.g. Percocet, hydromorphone, codeine). These medications can be helpful for some people, but they can also be dangerous, particularly when used for a long time. Many patients don't like the way opioids make them feel and would prefer alternative pain management strategies. Some people become addicted to opioids, have a difficult time reducing the dose of opioids, or have lasting health problems after using them.

People in this study will be randomized to either have usual care or a new pathway designed to improve pain control and decrease opioid use after knee replacements. This study will have an intervention coordinator who will assess patients before surgery and who will follow up with patients regularly after surgery to make sure their pain is controlled and to avoid long-term opioid use. This study will use education, physiotherapy, psychological therapy, ice/cold, and non-opioid pain medications. As pain medications may work differently in different patients, the coordinator will check on each patient to look for pain control and assist to reduce the amount of opioids used after surgery.

This study will help people have safer and more effective pain management after surgery which may lead to better recovery, higher satisfaction, and a lower risk of being harmed by opioids after surgery.

Enrollment: 102 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult (18+)
• Undergoing elective total knee arthroplasty (TKA) for knee arthritis
• Can use a simple electronic (phone or tablet) device
• Provide informed consent to participate

Exclusion criteria

• Revision surgery
• Simultaneous bilateral arthroplasties
• Unable to consent (e.g., cognitive disability or substantial language barrier without a support person)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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102 participants in 2 patient groups

Standard care group

Active Comparator group

Description:

This group will receive standard perioperative care, surgical treatment, and pain medications.

Treatment:

Other: Standard care

Opioid reduction group

Experimental group

Description:

Patients will participate in a multicomponent pathway coordinated by a trained coordinator who will facilitate patient participation and engagement with each interventional component.

Treatment:

Other: Multicomponent opioid reduction and pain management pathway