Preoperative Acupuncture for Total Knee or Hip Arthroplasty
Condition: Knee Arthropathy; Hip Arthropathy; Anxiety
MeSH terms: Joint Diseases
Study type: Interventional

Summary: 
      Open-label, randomized controlled trial to determine the effect of preoperative acupuncture
      on preoperative anxiety and postoperative pain for high-anxiety patients undergoing total hip
      or knee arthroplasty. The hypothesis is that preoperative acupuncture will reduce
      preoperative anxiety, reduce postoperative pain, reduce postoperative nausea and vomiting,
      reduce opioid consumption, and improve patient satisfaction.
    

Detailed description: 
      Acupuncture has been extensively practiced and studied worldwide, particularly as a part of
      Eastern medicine, but it is a relatively uncommon therapy offered in Western medical
      institutions, such as those in the United States. Considering the commonly cited benefits of
      acupuncture, such as reduced anxiety and pain, hospitals throughout the United States have
      the opportunity to implement acupuncture as a cost-effective and safe technique for improving
      surgical outcomes.

      Acupuncture administered in the preoperative period can be particularly effective for
      reducing preoperative anxiety, postoperative pain, postoperative opioid consumption, and
      postoperative nausea and vomiting. Consequently, preoperative acupuncture can improve patient
      satisfaction and decrease hospital costs. However, due to a lack of implementation and
      experience, further research is needed to establish the safety and efficacy of preoperative
      acupuncture in United States medical practices.

      At the Bone-and-Joint Institute at Hartford Hospital, where this study is proposed, a quality
      study on total knee or hip arthroplasty patients found that 21% of its monthly patients were
      "high-anxiety" according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS).
      Thus, there is a significant population of patients who would benefit from a procedure to
      reduce preoperative anxiety at our facility.

      This proposal is for a prospective, open-label, randomized controlled trial to determine the
      effect of preoperative acupuncture on preoperative anxiety and postoperative pain for
      high-anxiety patients undergoing total hip or knee arthroplasty. The hypothesis is that
      preoperative acupuncture will reduce preoperative anxiety and postoperative pain as well as
      reduce postoperative nausea and vomiting and opioid consumption and improve patient
      satisfaction. The study population is to include adult patients undergoing lower extremity
      total joint arthroplasty, including hip and knee joints, at the Bone-and-Joint Institute at
      Hartford Hospital.
    

Intervention name(s): Acupuncture needles
Intervention type(s): Device
Intervention description(s): The acupuncture intervention includes a combination of auricular and body acupuncture. The auricular points used are Shen men, Zero point, Tranquilizer point, and Master cerebral.
The body points used are the wrist PC6.
Other intervention name(s): DBC™ Detox-5 Acupuncture Needles (SKU: DTX.20X13) and ure needles o 1) SEIRIN J-Type Acupuncture Needles (SKU: SJ.18X30)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Single-center, prospective, unblinded, randomized controlled clinical trial
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Acupuncture; Total Knee Arthroplasty; Total hip arthroplasty; Anxiety; Pain