Pacira Pharmaceuticals, Inc. (NASDAQ:PCRX) today announced results from a 200-patient study evaluating the benefits of EXPAREL ® (bupivacaine liposome injectable suspension) as the foundation of a multimodal postsurgical pain management regimen in patients undergoing total knee arthroplasty (TKA), commonly known as total knee replacement. The findings show that patients treated with EXPAREL experienced better pain control with improved knee flexion and a shorter length of hospital stay compared to patients who received a femoral nerve block with a local anesthetic, the current standard of pain management for TKA. Additionally, the use of EXPAREL resulted in a substantial cost savings. The data were presented at the Marshall Steele 7th Annual Orthopedic and Spine Summit in San Antonio.
The study evaluated a matched cohort of 200 patients undergoing TKA, half of whom (n=100) received femoral nerve block, while the other half received EXPAREL infiltration. The investigators recorded average pain scores, knee flexion, length of stay, and performed a cost analysis for both groups.
Compared to patients who received a femoral nerve block, patients treated with EXPAREL experienced:
- Lower pain scores during the first 24 hours (4.0 in the EXPAREL group compared to 4.9 in the femoral nerve block group) and on day 2 after surgery (4.7 in the EXPAREL group compared to 5.3 in the femoral nerve block group)
- Greater improvement in knee flexion at both week 3 and week 9 follow up (109° to 121° for the EXPAREL group vs. 100° to 105° for the femoral nerve block group)
- Shorter overall length of hospital stay (2.2 days for the EXPAREL group vs. 2.5 days in the femoral nerve block group), with greater likelihood of discharge the day after surgery (12 percent of patients in the EXPAREL group compared to zero patients in the femoral nerve block group)
- A 55.5 percent reduction in medication and delivery system costs ($285 vs. $640, respectively, independent of additional cost savings related to anesthesia fees)
“While femoral nerve blocks have long been chosen for postsurgical analgesia following TKA, their use has been associated with quadriceps muscle weakness, which can lead to falls and negatively impact ambulation, which we know is an imperative step in the rehabilitation component of orthopedic surgery,” said Brandon Broome, M.D., the study’s lead investigator and a practicing orthopedic surgeon at the Steadman Hawkins Clinic of the Carolinas, in Greenville. “In our study we found that no patients in the EXPAREL group experienced quadriceps weakness, and that in a subgroup analysis, patients receiving EXPAREL demonstrated a mean daily ambulation of 138.8 feet, compared to 89.6 feet in patients with a femoral nerve block, making a strong case for the utility of EXPAREL in these procedures.”