Transdermal NSAID Matches Oral Celecoxib After Knee Replacement

Randomized trial finds a topical anti-inflammatory patch provided similar pain relief, function, and safety as oral therapy during the first 6 weeks after surgery.

By
Doug Brunk
July 2, 2026
4 min

Conexiant

Objective:

To compare the efficacy of a transdermal esflurbiprofen patch with oral celecoxib for post-operative pain control in total knee arthroplasty patients.

Approach:

Study Design: A single-center, prospective, randomized controlled noninferiority trial involving 100 patients aged 50 years or older undergoing primary unilateral total knee arthroplasty.
Intervention: Participants were randomly assigned to receive either a 40 mg transdermal esflurbiprofen patch or oral celecoxib 200 mg for 14 days, starting on postoperative day 1.
Pain Management: All patients received a multimodal pain management regimen including paracetamol, pregabalin, a continuous adductor canal block, and infiltration between the popliteal artery and posterior capsule.
Primary Endpoint: Pain intensity on postoperative day 14, measured by the visual analog scale.

Key Findings:

Pain scores improved significantly from baseline in both groups throughout follow-up.
Average pain scores at rest were 1.0 in the transdermal group and 0.8 in the oral celecoxib group by postoperative day 14.
Average pain scores with movement were 2.5 in the transdermal group and 2.3 in the oral celecoxib group by postoperative day 14.
No patients in either group required rescue morphine.
Recovery of physical function was similar in both groups, with no significant differences in mobility and strength tests.
Safety outcomes were comparable, with no serious adverse events reported.