Effect of pre-operative pain treatment by means of duloxetine on postoperative outcome after total hip or knee arthroplasty- The DOA study

Total Joint Replacement is considered a successful treatment for end stage osteoarthritis. However, residual pain after Total Joint Replacement forms a substantial problem affecting up to 23% - 34% of patients after Total Hip or Knee Replacement (THR/TKR). There is a growing amount of evidence in literature that pain in osteoarthritis can be amplified by sensitization of the central nervous system. Moreover, preoperative characteristics of central sensitization are associated with poorer postoperative outcomes, like residual pain. Therefore preoperative treatment of central sensitization may reduce residual pain after THR/TKR. Duloxetine, a serotonin and norepinephrine reuptake inhibitor, has proven to be effective in several chronic pain syndromes in which central sensitization is believed to be involved. This trial assesses the postoperative effects on pain and function of a preoperative duloxetine treatment to a group of patients scheduled for THR/TKR and who likely suffer from a degree of central sensitization, compared to usual care.

Preoperative pain treatment by means of duloxetine will improve postoperative outcome after total hip or knee arthroplasty by reducing residual pain

Baseline, after two weeks, 8 weeks and 10 weeks of duloxetine treatment, 1 day before surgery, 48 hours after surgery, 6 weeks, 6 months and 12 months after surgery

Preoperative treatment with Duloxetine for a period of 10 weeks