title: Acupuncture provides short-term pain relief for patients in a total joint replacement program.
abstract: OBJECTIVE
  Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain.
  
  
  METHODS
  A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management.
  
  
  METHODS
  The Joint Replacement Center at Abbott Northwestern Hospital, a 630-bed teaching and specialty hospital in Minneapolis, Minnesota from 2010 to 2012.
  
  
  METHODS
  Our sample included 2,500 admissions of total hip (THR) and total knee replacement (TKR) patients.
  
  
  METHODS
  Self-reported pain was assessed before and after acupuncture using a 0-10 scale and categorized as none/mild (0-4) and moderate/severe pain (5-10).
  
  
  RESULTS
  Seventy-five percent of admissions included acupuncture. Women (Odds Ratio: 1.48, 95% Confidence Interval (CI): 1.22, 1.81) had higher odds of receiving acupuncture compared to men, and nonwhite patients (Odds Ratio: 0.55, 95% CI: 0.39, 0.78) had lower odds of receiving acupuncture compared to white patients. Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture.
  
  
  CONCLUSIONS
  Acupuncture may be a viable adjunct to pharmacological approaches for pain management after THR or TKR.
authors.affiliation: Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Crespin
authors.affiliation: Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota.
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Griffin
authors.affiliation: Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota.
authors.forename: Jill R
authors.initials: JR
authors.lastname: Johnson
authors.affiliation: Penny George Institute for Health and Healing, Allina Health, Abbott Northwestern Hospital, Minneapolis, Minnesota.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Miller
authors.affiliation: Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Finch
authors.affiliation: Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota.
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Rivard
authors.affiliation: Twin Cities Orthopedics, Edina, Minnesota.
authors.forename: Scott
authors.initials: S
authors.lastname: Anseth
authors.affiliation: Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota.
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Dusek
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods* / Q000639:trends; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000639:trends; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000639:trends; D010147:Pain Measurement / Q000379:methods / Q000639:trends; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Acupuncture; Integrative Medicine; Multimodal Pain Management; Postoperative Pain; Total Joint Replacement