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SM Journal of Orthopedics

Bipolar Sealer may Decrease Pain and Opioid Consumption after Primary Total Knee Arthroplasty - A Preliminary Trial

[ ISSN : 2473-067X ]

Abstract
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Received: 30-Jan-2025

Accepted: 25-Feb-2025

Published: 27-Feb-2025

Research Article | Volume 8 - Issue 1 | Article DOI :

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Christopher X Carrera1, Elliot S Kim2, Kawsu Barry3, Audrey Kobayashi2, Yama Afghanyar4, Michael Paskewicz2, Elena Losina2 and Wolfgang Fitz2*

1Warren Alpert Medical School at Brown University, 222 Richmond St, Providence, RI 02903, USA

2Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA

3The Iowa clinic, 5950 University Ave, West Des Moines, IA, 50266, USA

4Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany

Corresponding Author:

Wolfgang Fitz, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA

Keywords

Arthroplasty; Pain Ccore; Narcotic Consumption; Bipolar Sealer; Monopolar Electrocautery.

Abstract

Background: Bipolar sealer technology provides a continuous saline flow effectively maintaining tissue temperatures below 100°C and theoretically leading to decreased charring of soft tissue. We investigate whether this results in less pain and reduced narcotic consumption in patients following Total Knee Arthroplasty (TKA).

Methods: A retrospective review of prospectively collected data of 100 primary unilateral TKAs were divided into two historical cohorts. Each Cohort consisted of 50 consecutive patients before and after switching from a monopolar Bovie to the bipolar sealer. All other perioperative variables such as multimodal protocols, no use of tourniquet, surgical technique or perioperative mobilization were identical. All patients were discharged the next day 24 hours within surgery. Pain measurements using a Visual Analog Scale (VAS) and narcotic consumption were retracted from the longitudinal medical records and analyzed for the day of surgery, day of discharge and in total.

Results: Bipolar sealer patients reported significantly lower pain scores and narcotic usage. Day of surgery pain levels were comparatively reduced from a VAS of 4.1 to 2.7 (p < .05) and day of discharge pain levels were reduced from 4.5 to 3.1 (p < .0001), reductions of 33% and 31% respectively. Total ME administered was reduced from 35.9 mg to 26.2mg (p < .05). The preclinical characteristics of each patient cohort were not associated with the pain outcomes nor ME consumption.

Conclusion: Our preliminary trial revealed a significant reduction in pain levels and narcotic consumption in patients following unilateral TKAs with bipolar sealing technology compared to the use of the standard Bovie. This study suggests that this technology may decrease pain and narcotic consumption in patients using the exact same perioperative management. The future will show whether the increased cost of this technology will lead to a more widespread use.

Citation

Carrera CX, Kim ES, Barry K, Kobayashi A, Fitz W et al. (2025) Bipolar Sealer may Decrease Pain and Opioid Consumption after Primary Total Knee Arthroplasty - A Preliminary Trial. SM J Orthop 8: 6.