December 01, 2025
2 min read
Key takeaways:
- Change in hemoglobin did not differ between patients taking NSAIDs before TJA and those who stopped NSAID use.
- There were also no differences in blood loss, surgical visualization and blood transfusion.
DALLAS — Results presented here showed the use of NSAIDs prior to total joint arthroplasty did not increase blood loss, blood transfusion requirements, exposure difficulty or bleeding-related complications.
“In general, our preoperative protocols are having patients stop taking NSAIDs 5, 7 or sometimes 10 days before surgery,” Peter A. Gold, MD, hip and knee replacement surgeon at Panorama Orthopedics and Spine Center, told Healio. “These results challenge that dogma. We can stop doing that for our patients and allow them to continue to take NSAIDs before surgery.”
Gold and colleagues randomly assigned 137 patients undergoing primary total hip arthroplasty or partial or total knee arthroplasty to either continue NSAIDs until the day before surgery (n = 68) or stop NSAIDs 7 days before surgery (n = 69).
“Our primary outcome was change in hemoglobin and we used a point-of-care test,” Gold said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “We measured this immediately preoperatively as well as on postoperative day 0, which was about 2 to 4 hours after surgery before discharge, and again at their 2-week postoperative follow-up.”
Gold said secondary outcomes included intraoperative blood loss, operative time, tourniquet time, surgical exposure spore, Hip Disability and Osteoarthritis Outcome Score and KOOS scores for patient-reported outcomes, range of motion and complications.
In his presentation, Gold said there was no difference in the change of hemoglobin at postoperative day 0 and 2-week follow-up between the two groups. Patients in the NSAID group and no NSAID group also had no significant differences with intraoperative blood loss, surgical visualization score or blood transfusion.
Although there was a statistically significant but not clinically significant difference in operative times when all TJAs were considered, Gold said this difference went away when analyzing hips and knees separately. Gold also reported no differences in patient-reported outcomes at 6 weeks and no differences in range of motion.
“The best part about these results is that we showed there really is no difference. There was no significant increase in bleeding, no increase in blood loss and no visualization problems with the procedure,” Gold told Healio. “This is a great study for all of us to go back to our hospitals, to our preop teams and make it OK for patients to continue taking these medications that helped them with pain and function before surgery.”
For more information:
Peter A. Gold, MD, can be reached at pgold12@gmail.com.
Sources/Disclosures
Source:
Foran JRH, et al. Paper 31. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Oct. 23-26, 2025; Dallas.
Disclosures:
Gold reports no relevant financial disclosures.
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