AN EVALUATION OF PREOPERATIVE AND POSTOPERATIVE NONSTEROIDAL ANTIINFLAMMATORY DRUGS IN PATIENTS UNDERGOING KNEE ARTHROSCOPY - A PROSPECTIVE, RANDOMIZED, DOUBLE-BLINDED STUDY

The potential benefits of a nonsteroidal antiinflammatory drug to 67 p atients undergoing knee arthroscopy were evaluated in a prospective, r andomized, placebo-controlled, double-blinded study. Group A received the drug (diclofenac, 75 mg twice daily) for 3 to 5 days before and fo r 7 days after surgery. Group B received a placebo preoperatively and the drug postoperatively. Group C received a placebo at both times. Co deine was available postoperatively for all patients if needed. Outcom es reported by the subjects included pain, crutch use, and return to a ctivities. Outcomes assessed by physicians included knee effusion, ran ge of motion, and gait. Knee flexion and extension strengths were meas ured isokinetically pre- and postoperatively. Pain scores on the 1st p ostoperative day were higher in Group C than in Group A. Pain scores a t all other time points were not significantly different in the three treatment groups. Groups A and B required less codeine during the firs t 72 hours after surgery than Group C (mean, 2.9 +/- 1.0 versus 6.8 +/ - 1.0 pills). Recovery of function, recovery of strength, and physical examination parameters were not significantly different in the three treatment groups. Diclofenac was an effective analgesic in the immedia te postoperative period. Recovery from arthroscopy, however, was not e nhanced by taking the drug.