Evidence map›Paper›PMID 38360686›Full record

ArticlePilot and feasibility studies2024

Opioid reduction and enhanced recovery in orthopaedic surgery (OREOS): a protocol for a feasibility randomised controlled trial in patients undergoing total knee arthroplasty.

Kim Madden, Sushmitha Pallapothu, Darren Young Shing, Anthony Adili, Mohit Bhandari, Lisa Carlesso, Moin Khan, Ydo V Kleinlugtenbelt, Adrijana Krsmanovic, Matilda Nowakowski and 8 more

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In one paragraph

Article in Pilot and feasibility studies, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04968132 (Opioid Reduction in Orthopaedic Surgery), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04968132 nacompletednot on this map

Opioid Reduction in Orthopaedic Surgery (OREOS): a Feasibility Randomized Controlled Trial in Knee Replacement Patients

TypeinterventionalSponsorKim MaddenRan2022 to 2024Enrolled102ConditionsKnee Osteoarthritis, Chronic Post Operative PainArmsMulticomponent opioid reduction and pain management pathway, Standard care
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Kim MaddenDepartment of Surgery, McMaster University, Hamilton, Canada. maddenk@mcmaster.ca.ORCID http://orcid.org/0000-0002-2861-9636
Sushmitha PallapothuDepartment of Health Research Methods, McMaster University, Hamilton, Canada.
Darren Young ShingDepartment of Medicine, University of Ottawa, Ottawa, Canada.
Anthony AdiliDepartment of Surgery, McMaster University, Hamilton, Canada.
Mohit BhandariDepartment of Surgery, McMaster University, Hamilton, Canada.
Lisa CarlessoSchool of Rehabilitation Science, McMaster University, Hamilton, Canada.
Moin KhanDepartment of Surgery, McMaster University, Hamilton, Canada.
Ydo V KleinlugtenbeltDeventer Hospital, Department of Orthopaedics, Schalkhaar, The Netherlands.
Adrijana KrsmanovicResearch Institute of St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Matilda NowakowskiResearch Institute of St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Tara PackhamSchool of Rehabilitation Science, McMaster University, Hamilton, Canada.
Eric RomerilHamilton Health Sciences-Juravinski Hospital, Hamilton, Canada.
Jean-Eric TarrideResearch Institute of St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Lehana ThabaneResearch Institute of St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Daniel M TushinskiDepartment of Surgery, McMaster University, Hamilton, Canada.
Christine WallaceResearch Institute of St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Mitchell WinemakerHamilton Health Sciences-Juravinski Hospital, Hamilton, Canada.
Harsha ShanthannaDepartment of Surgery, McMaster University, Hamilton, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnee arthritis is a leading cause of limited function and long-term disability in older adults. Despite a technically successful total knee arthroplasty (TKA), around 20% of patients continue to have persisting pain with reduced function, and low quality of life. Many of them continue using opioids for pain control, which puts them at risk for potential long-term adverse effects such as dependence, overdose and risk of falls. Although persisting pain and opioid use after TKA have been recognised to be important issues, individual strategies to decrease their burden have limitations and multi-component interventions, despite their potential, have not been well studied. In this study, we propose a multi-component pathway including personalized pain management, facilitated by a pain management coordinator. The objectives of this pilot trial are to evaluate feasibility (recruitment, retention, and adherence), along with opioid-free pain control at 8 weeks after TKA.

methodsThis is a protocol for a multicentre pilot randomised controlled trial using a 2-arm parallel group design. Adult participants undergoing unilateral total knee arthroplasty will be considered for inclusion and randomised to control and intervention groups. Participants in the intervention group will receive support from a pain management coordinator who will facilitate a multicomponent pain management pathway including (1) preoperative education on pain and opioid use, (2) preoperative risk identification and mitigation, (3) personalized post-discharge analgesic prescriptions and (4) continued support for pain control and recovery up to 8 weeks post-op. Participants in the control group will undergo usual care. The primary outcomes of this pilot trial are to assess the feasibility of participant recruitment, retention, and adherence to the interventions, and key secondary outcomes are persisting pain and opioid use. DISCUSSION: The results of this trial will determine the feasibility of conducting a definitive trial for the implementation of a multicomponent pain pathway to improve pain control and reduce harms using a coordinated approach, while keeping an emphasis on patient centred care and shared decision making.

trial registrationProspectively registered in Clinicaltrials.gov (NCT04968132).

Indexed as

FeasibilityKnee arthroplastyMulticomponent interventionOpioid reductionPersisting pain

Identifiers

PMID38360686
PMCPMC10868001

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.