Oral acetaminophen has widely been accepted as a safe, effective, and low-cost analgesic medication. Despite the numerous high and moderate quality randomized clinical trials investigating perioperative acetaminophen in the setting of a primary TJA, we lack specific evidence to guide a recommendation on the use of oral acetaminophen after discharge. As a result, we must rely on the available evidence regarding acetaminophen in the nonsurgical treatment of osteoarthritis and its use during the perioperative period of primary TJA to guide our recommendation. In the setting of nonsurgical treatment of osteoarthritis of the knee, direct meta-analysis of oral acetaminophen showed a significant improvement in pain and function compared to an oral placebo. Lastly, the results from the current clinical practice guidelines has shown the effectiveness of oral acetaminophen to reduce postoperative pain and opioid consumption during the inpatient period following primary TJA.
Although acetaminophen has not been proven to be effective in isolation for postoperative pain management following primary TJA, it has been demonstrated as an effective adjunct as part of a multimodal pain management protocol. When used in conjunction with other non-opioid analgesic medications, patients experienced a decreased risk of medical complications. Therefore, we can support the use of oral acetaminophen after discharge as part of a multimodal pain regimen.
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