relievrx for total knee arthroplasty (tka) for the reduction of acute postoperative pain and opioid use

Conditions: Opioid Use; Arthropathy of Knee; Pain, Postoperative

Summary: this is a single-center, prospective, randomized, controlled study of the appliedvr relievrx headset in subjects undergoing total knee arthroplasty (tka). this study will evaluate two primary endpoints - effectiveness of a single use of relievrx in the reduction of acute postoperative pain by 20%; and overall effectiveness of relievrx as an opioid-sparing intervention, where opioid consumption is reduced by at least 20% over a 90-day postoperative period in the interventional, standard of care (soc) plus relievrx group compared to the control, soc group.

this is a single-center, prospective, randomized, controlled study of the appliedvr relievrx headset in subjects undergoing total knee arthroplasty (tka). patients will be randomized to one of the two groups after study enrollment, and patients in the test arm will be educated about the device preoperatively to facilitate its use in the acute post-operative period. the goals of vr will be presented in the context of an alternate method of pain control to opioids. this study will evaluate two primary endpoints - effectiveness of a single use of relievrx in the reduction of acute postoperative pain by 20%; and overall effectiveness of relievrx as an opioid-sparing intervention, where opioid consumption is reduced by at least 20% over a 90-day postoperative period in the interventional, standard of care (soc) plus relievrx group compared to the control, soc group.

Eligibility criteria:
inclusion criteria: 1. subject is ≥ 18 years old 2. subject is willing and able to read, comprehend, and sign the study informed consent form in english prior to study specific procedure 3. subject is scheduled for total knee arthroplasty (tka) surgery 4. subject has a score of 1-3 based on the american society of anesthesiologists physical status classification system 5. subject attended the pre-op total joint arthroplasty patient education class (proven recovery program©) 6. subject agrees to be enrolled in force therapeutics, a web-based, digital rehabilitation and education program 7. subject has family member or community support during post-surgical recovery period exclusion criteria: 1. diagnosed with chronic pain syndrome 2. body mass index (bmi) ≥ 40 3. current tobacco user at time of surgery 4. uncontrolled sleep apnea 5. bilateral tka 6. current or recent history (in past year) of substance abuse disorder 7. uncontrolled diabetes (hba1c ≥ 7.0) 7.8 at time of surgery 8. history of pulmonary embolism (pe) or deep vein thrombosis (dvt) 9. currently being treated with blood thinners at time of surgery 10. diagnosis of rheumatoid arthritis (ra) 11. has methicillin-resistant staphylococcus aureus (mrsa) 12. currently pregnant/breastfeeding or planning to in the next 3 months 13. comorbidities including neurological, psychosocial, sensory, or other disorders that may impact pain perception 14. diagnosis of epilepsy, dementia, migraines, or other neurological disorders that may prevent vr usage, and/or other medical conditions predisposed to nausea and dizziness 15. hypersensitivity to flashing lights or motion 16. claustrophobia 17. lack of stereoscopic vision 18. severe hearing impairment 19. injury to eyes, face, or neck that prevents comfortable vr usage