JOA - 2026-05-04 - Journal Article
Nanotechnology-Based Device Reduces Pain and Immediate Opioid Requirements, and Facilitates Earlier Discharge from the Hospital Following Total Knee Arthroplasty: A Randomized Placebo-Controlled Trial.
Klatt BA, O'Malley M, Ayazbekova A, Sylvia Lin HH, Sadhasivam S, Chelly JE
Topics
Key Takeaway
A nanotechnology-based wearable device reduced 24-hour postoperative opioid consumption by 26% (25.6 vs 34.4 mg MME, P=0.015) and shortened hospital LOS by 19% (20.8 vs 25.7 hours, P=0.006) compared to sham in primary TKA.
Summary Depth
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Summary
This single-center RCT evaluated whether a nanotechnology-based wearable device (NBD), worn 12 hours/day for 2 weeks starting in the recovery room, reduces opioid consumption and improves perioperative outcomes after primary TKA versus sham device. Active NBD produced a 26% reduction in 24-hour opioid use, 19% shorter LOS, 14% lower pain-at-rest scores at week 1, 30% reduction in PONV, and 41% reduction in rescue antiemetic use. No between-group differences in knee ROM or opioid misuse risk were reported at 6 weeks.
Key Limitation
The mechanism of action of the NBD is unreported, precluding assessment of whether the observed effects are device-specific or attributable to an uncontrolled confound not neutralized by the sham design.
Original Abstract
BACKGROUND
Opioids are often used to control pain following total knee arthroplasty (TKA). Opioid-sparing pain relief tools are needed in the current setting of the opioid crisis. This prospective randomized placebo-controlled study assessed the ability of a nanotechnology-based device (NBD) to reduce pain and opioid consumption following TKA.
METHODS
A total of 156 patients were included (79 in the active NBD group and 77 in the sham NBD group). In the recovery room, patients enrolled were randomized (1:1) to either an active NBD or sham group and were asked to wear the NBD 12 hours a day for two weeks. Patients were followed for six weeks following surgery to determine the effectiveness of active NBD to reduce pain, opioid use, hospital length of stay (LOS), use, postoperative nausea and vomiting (PONV), risk of opioid misuse, and knee range of motion.
RESULTS
The use of active NBD was associated with a 26% reduction in opioid consumption during the first 24 hours before discharge (25.6 in the active NBD versus 34.4 mg in the sham group, P = 0.015) and a 19% shorter LOS (20.8 versus 25.7 hours, P = 0.006). The active NBD group showed a 14% reduction in pain at rest score at week one and a reduction of 30% in postoperative nausea and vomiting (PONV) and 41% in use of rescue antiemetics compared to the sham NBD group.
CONCLUSION
This randomized placebo-controlled study demonstrates that the use of NBD is significantly associated with an immediate reduction in postoperative opioid use, PONV, use of rescue antiemetics, and LOS. However, additional large multicenter prospective studies are needed to confirm and scale the clinical and economic benefits of NBD following TKA.