Nanotechnology-Based Device Reduces Pain and Immediate Opioid Requirements, and Facilitates Earlier Discharge from the Hospital Following Total Knee Arthroplasty: A Randomized Placebo-Controlled Trial

J Arthroplasty. 2026 May 4:S0883-5403(26)00418-3. doi: 10.1016/j.arth.2026.04.083. Online ahead of print.

ABSTRACT

BACKGROUND: Opioids are often used to control pain following total knee arthroplasty (TKA). Opioid-sparing pain relief tools are needed in the current setting of the opioid crisis. This prospective randomized placebo-controlled study assessed the ability of a nanotechnology-based device (NBD) to reduce pain and opioid consumption following TKA.

METHODS: A total of 156 patients were included (79 in the active NBD group and 77 in the sham NBD group). In the recovery room, patients enrolled were randomized (1:1) to either an active NBD or sham group and were asked to wear the NBD 12 hours a day for two weeks. Patients were followed for six weeks following surgery to determine the effectiveness of active NBD to reduce pain, opioid use, hospital length of stay (LOS), use, postoperative nausea and vomiting (PONV), risk of opioid misuse, and knee range of motion.

RESULTS: The use of active NBD was associated with a 26% reduction in opioid consumption during the first 24 hours before discharge (25.6 in the active NBD versus 34.4 mg in the sham group, P = 0.015) and a 19% shorter LOS (20.8 versus 25.7 hours, P = 0.006). The active NBD group showed a 14% reduction in pain at rest score at week one and a reduction of 30% in postoperative nausea and vomiting (PONV) and 41% in use of rescue antiemetics compared to the sham NBD group.

CONCLUSION: This randomized placebo-controlled study demonstrates that the use of NBD is significantly associated with an immediate reduction in postoperative opioid use, PONV, use of rescue antiemetics, and LOS. However, additional large multicenter prospective studies are needed to confirm and scale the clinical and economic benefits of NBD following TKA.

PMID:42092468 | DOI:10.1016/j.arth.2026.04.083