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American Academy of Orthopaedic SurgeonsOrthopaedic Surgery2020advanced

Acetaminophen in Total Joint Arthroplasty

Published by American Association of Hip and Knee Surgeons · AAOS Clinical Practice Guidelines and Systematic Review Methodology

3Recommendations
20References

Summary

AI-generated

This clinical practice guideline evaluates the efficacy and safety of perioperative intravenous and oral acetaminophen for pain management and opioid consumption reduction in patients undergoing primary total joint arthroplasty.

acetaminophentotal joint arthroplastyAAHKSorthopaedic surgerypain managementopioid reductionmultimodal analgesiaguidelines

Key Takeaways

  • 1
    Administration of IV or oral acetaminophen reduces pain and opioid consumption during the perioperative period of a primary TJA.
  • 2
    Oral acetaminophen is recommended after discharge as part of a multimodal pain regimen.
  • 3
    Administration of IV or oral acetaminophen is safe and does not increase the risk of complications following primary TJA.

Key Recommendations

Guideline Question 1

  • 1

    Administration of IV or oral acetaminophen reduces pain and opioid consumption during the perioperative period of a primary TJA.

    ModerateEvidence: High to moderate qualityTreatment

Guideline Question 2

  • 2

    In the absence of reliable evidence, it is the opinion of the workgroup that oral acetaminophen may be used after discharge as part of a multimodal pain regimen, as it is a low-cost and low-risk treatment for pain after discharge from a primary TJA.

    ConsensusEvidence: Absence of reliable evidenceTreatment

Guideline Question 3

  • 3

    Administration of IV or oral acetaminophen does not increase the risk of complications following primary TJA.

    StrongEvidence: High and moderate qualitySafety

Scope & Objectives

Clinical Topic

Acetaminophen in Total Joint Arthroplasty

Objectives

To improve the treatment of orthopaedic surgical patients and reduce practice variation by promoting a multidisciplinary evidenced-base approach on the use of acetaminophen following primary TJA.

Target Patient Population

Patients undergoing primary total joint arthroplasty (TJA)

Target Providers

Orthopaedic SurgeonsAnesthesiologistsPain Medicine Specialists

Patient Criteria & Setting

Therapeutic Area

Pain Management

Guideline Scope

TreatmentManagement

Care Settings

PerioperativePostoperativeOutpatient

Evidence Grading

System: AAOS Clinical Practice Guidelines and Systematic Review Methodology

Safety & Contraindications

Contraindications

  • Hepatotoxicity

Authors & Contributors

Yale A. Fillingham MDCharles P. Hannon MDMBAGreg A. Erens MDAsokumar Buvanendran MDWilliam G. Hamilton MDCraig J. Della Valle MD

Guideline Features

Based on systematic reviewMultidisciplinary

Learning Context

Difficulty

advanced

Learning Paths

AcetaminophenTotal Joint ArthroplastyPain ManagementMultimodal AnalgesiaOrthopaedic SurgeryPostoperative Care