Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

A new study published in JAMA, has found that a drug recently licensed in the UK has no effect on post-operative knee replacement recovery or pain, compared to the current treatment when administered at site of surgery.

Knee replacement is highly successful for treating severe arthritis. There are 100,000 people who undergo knee replacement surgery every year in the UK, with numbers set to rise significantly in future.

It remains however a painful procedure with nearly half of patients reporting severe pain post-operatively. Currently pain control is provided by injecting a local anaesthetic of bupivacaine hydrochloride around the knee during surgery providing good pain relief for 12 to 24 hours. However, patients typically experienced the worst pain the next morning when they are encouraged to bend their knee and get out of bed.

Researchers at the Universities of Oxford and Leeds developed the SPAARK (Study of Peri-Articular Anaesthetic for Replacement of the Knee) Trial, to test whether liposomal bupivacaine, a post-operative pain treatment widely used in the USA would be more effective at managing the pain compared to current treatments. The findings have been published in JAMA.

Lead author Thomas Hamilton, Academic Clinical Lecturer in Trauma and Orthopaedic Surgery at NDORMS said: "We found that liposomal bupivacaine injected at the surgical side during knee replacement did not improve post-operative recovery, compared to those receiving bupivacaine hydrochloride alone. We saw no difference in Quality of Recovery score at 72 hours, nor pain assessed using pain visual analogue scale area under the curve at 6 to 72 hours. The results of this study do not support the use of peri-articular liposomal bupivacaine for knee replacement ."

Prof Hemant Pandit (Professor of Orthopaedic Surgery, University of Leeds and University of Oxford) senior author and chief investigator of the study added: "This is the largest randomised controlled trial in the world to assess the effectiveness of liposomal bupivacaine in achieving superior pain relief in patients undergoing a knee replacement. The study results are timely and demonstrate that there is no additional benefit in the pain relief experienced by patients receiving Liposomal Bupivacaine and therefore the drug's use in routine NHS practice cannot be justified."

The research was funded by a grant from the NIHR Research for Patient Benefit Programme with the study drug (and additional funding) provided by Pacira Pharmaceuticals.

Similar stories

Emergency to use the FORCE pathway for wrist fractures in children

New research from the University of Oxford has shown that doctors can simplify treatment for the most common fracture in children, reducing NHS costs.

Kennedy researchers awarded funding to improve the understanding of inflammatory bowel diseases

A new £1.5M grant from the Medical Research Council (MRC) to the Powrie Group at the Kennedy Institute will help define different pathotypes of inflammatory bowel diseases that could lead to better and more focused treatments for patients.

Yoshi Itoh wins the International Dupuytren Award 2022

Yoshi Itoh, Associate Professor and Principal Investigator Cell Migration Group at the Kennedy Institute has been awarded the International Dupuytren Award 2022.

Taking a break from immune-suppressing medicines doubles the antibody response to COVID-19 booster vaccination

The Oxford Clinical Trials Research Unit (OCTRU) at NDORMS played a key role in the VROOM study which found that pausing immune-suppressing medicines such as methotrexate can increase the response to COVID-19 booster jabs.

Ten Years of Athena Swan in the Medical Sciences Division

2022 marks ten years since the first Athena Swan Bronze applications from the Medical Sciences Division. Ten years later, and all 16 departments in the Division have achieved a Silver Award. We look at NDORMS’ Athena Swan journey.

NDORMS researchers awarded Associate Professor title

The University of Oxford has awarded the title of Associate Professor to Adam Cribbs and Luke Jostins.