Acetaminophen and Postoperative Complications
Administration of IV or oral acetaminophen does not increase the risk of complications following primary TJA
Anesthesia and Analgesia in Total Joint Arthroplasty (2020)
Developed by: American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, The Hip Society, and The Knee Society

Rationale

Among the reviewed high and moderate quality randomized clinical trials, eleven studies reported on complications related to the administration of acetaminophen.[2-6, 12, 13, 15-18] Qualitative examination demonstrated no consistent difference between IV acetaminophen, oral acetaminophen, and placebo. Direct meta-analysis was only capable of being performed for IV acetaminophen, which showed no significant difference with regards to any complication (0.98 relative risk; 95% confidence interval of 0.83 to 1.16) or vomiting (1.16 relative risk; 95% confidence interval of 0.30 to 4.45). Therefore, IV and oral acetaminophen are considered to be safe analgesic medications to administer during the perioperative episode of a primary TJA.