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Celecoxib and loxoprofen provide superior postoperative acute pain relief compared with acetaminophen, with celecoxib showing greater overall improvement in VAS pain scores and subjective pain perception at 2 days after knee surgery.
In a high-impact randomized controlled trial assessing postoperative acute pain management, researchers have confirmed that celecoxib (selective COX-2 inhibitor) and loxoprofen (non-selective NSAID) outperform acetaminophen following arthroscopic knee procedures, including anterior cruciate ligament (ACL) reconstruction and meniscal repair/meniscectomy.
Researchers conducted this study to determine the comparative efficacy of:
Medications were administered orally starting 3 hours postoperatively, and pain intensity was assessed using a 100-mm visual analog scale (VAS) along with subjective pain-relief evaluations for up to 2 postoperative days. Data were analyzed using a per-protocol approach. Out of 432 screened patients, 160 patients fulfilled the inclusion criteria and were recruited in the study. All the subjects had undergone second-look procedures involving removal of internal fixation after ACL reconstruction or arthroscopic meniscectomy/meniscal repair.
Key Results: COX-2 Inhibitors Show Clear Advantage
1. Celecoxib vs. acetaminophen
At postoperative day 2, celecoxib illustrated:
Celecoxib consistently outperformed acetaminophen across multiple pain parameters.
2. Loxoprofen vs. acetaminophen
3. Celecoxib vs. loxoprofen
4. Safety outcomes
This trial strengthens evidence that:
For clinicians designing multimodal analgesia protocols, especially in arthroscopic knee surgery, COX-2 inhibitors and NSAIDs appear to offer measurable advantages over acetaminophen monotherapy.
Journal of Orthopaedic Science
Comparison of the effects of treatment with celecoxib, loxoprofen, and acetaminophen on postoperative acute pain after arthroscopic knee surgery: A randomized, parallel-group trial
Akira Onda et al.
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