Total Joint Arthroplasty Study1,2: Medicare and Commercial
Two studies analyzed the impact that EXPAREL, as part of an ERAS pathway, had on same-day discharge. The Medicare-focused study analyzed the outcome and feasibility of same-day discharge using an ERAS protocol in the inpatient setting, while the commercial insurance-focused study analyzed outcomes in an ASC.
- Medicare: Orthopedic center in Oregon
- Commercial: ASC in Oregon
- Medicare and Commercial: Retrospective chart review
- Medicare: 601 unique patients who underwent primary TKA (n=337) or THA (n=308) with the use of EXPAREL
- Commercial: 220 unique patients who underwent primary TKA (n=113) or THA (n=138) with the use of EXPAREL in a freestanding ASC
- Medicare: Within 30 days after surgery, 1.1% of patients experienced a severe AE and 0.5% of patients experienced a minor AE
- Commercial: Within 30 days after surgery, 6 patients experienced a severe AE and 1 patient experienced a minor AE
Clinical and Economic Outcomes
In patients who received EXPAREL for analgesia
- 84% of patients were discharged on the day of surgery
- 100% of patients were discharged on the day of surgery
High pain management satisfaction
- 98.3% of patients were “very much” or a “good amount” satisfied with pain management
- 99.3% of patients were “very much” or a “good amount” satisfied with pain management
Postsurgical opioid use
- 84.2% of patients did not require an opioid prescription beyond the initial 7-day prescription provided at discharge*
AE=adverse event; ASC=ambulatory surgery center; ERAS=enhanced recovery after surgery; THA=total hip arthroplasty; TJA=total joint arthroplasty; TKA=total knee arthroplasty.
*The clinical benefit of the decrease in opioid consumption was not demonstrated in pivotal trials.