Incorporating Acupuncture Into ERAS for Ambulatory Total Hip Replacement (THR) Surgery

NCT ID: NCT05384860

Last Updated: 2025-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

484 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-06

Study Completion Date

2025-04-04

Brief Summary

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At this time, no formal ERAS (enhanced recovery after surgery) protocol exists for THR that incorporates perioperative acupuncture. Developing, and more importantly, validating a preliminary fast-track protocol for THR can have a significant impact on reducing recovery time and improving the rate at which this subgroup of surgeries is done on an outpatient basis. Furthermore, previous studies of acupuncture as an adjunctive therapy for postoperative analgesia have primarily investigated patient satisfaction rather than the impact on postoperative opioid consumption.

The majority of studies also place acupuncture needles preoperatively, rather than following induction of anesthesia (intra-operatively). This study hopes to show that placing auricular therapy needles intraoperatively is a feasible part of a protocol for motivated patients to minimize opioids after total knee arthroplasty. The prospect of incorporating intraoperative acupuncture as an adjunct into said protocol is very attractive given its low cost, its safety profile, its ease of administration, and the growing evidence supporting its efficacy. This study would provide further clarity on whether perioperative acupuncture can effectively reduce hospital length of stay and post-operative opioid consumption, in addition to evaluating the role of perioperative acupuncture in improving recovery after THR as part of a multimodal fast-track protocol.

Detailed Description

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Conditions

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Acupuncture Hip Surgery Opioid Use

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Subjects were randomly assigned to receive Acupuncture, or No Acupuncture based on a 1:1 schedule with blocks of four created prior to study initiation using SAS version 9.4 (SAS Institute; Cary, NC) by a member of the biostatistics core not otherwise involved in the trial.

Treatment assignments were transcribed onto notecards and sealed in opaque, consecutively numbered envelopes by a research assistant not otherwise involved in the trial.

After patient consent and prior to anesthesia start, the research assistant involved in the trial handed the randomization envelope to the medical acupuncturist. All patients and research assistants involved with data collection will be blinded to the group allocation.

Randomization lists will be accessed by an intra-op monitor RA who is not otherwise involved in the study in any other aspect.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Both patients and research assistants (RAs)collecting data from the patients will be blinded.

Study Groups

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Active Acupuncture Group

For the patients randomized to the acupuncture group, once sedation has been deemed adequate by the anesthesiologist, a certified medical acupuncturist will perform ipsilateral Auricular Trauma Protocol (ATP) acupuncture at eight ear points (Hypothalamus, Amygdala, Hippocampus, Prefrontal Cortex, Point Zero, Shen Men, Insula, Vagus) with 30Hz electrostimulation at two of those points (Shen Men and Hypothalamus). Acupuncture needles will be left in place and stimulated for 60 min and then removed.

Group Type ACTIVE_COMPARATOR

Auricular Trauma Protocol (ATP) Acupuncture

Intervention Type DEVICE

Small filiform (needle) like needles use low frequency electrostimulation at eight ear points for 60 minutes while patient is sedated during surgery. All other aspects of the surgical procedure will go as planned according to the hospital's standard of care.

Placebo No Acupuncture Group

These patients will not receive acupuncture treatment during surgery, their surgery will continue as normal.

Group Type PLACEBO_COMPARATOR

No Acupuncture Group

Intervention Type OTHER

This involves not receiving the acupuncture treatment and surgery going entirely as normal according to the hospital's standard of care.

Interventions

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Auricular Trauma Protocol (ATP) Acupuncture

Small filiform (needle) like needles use low frequency electrostimulation at eight ear points for 60 minutes while patient is sedated during surgery. All other aspects of the surgical procedure will go as planned according to the hospital's standard of care.

Intervention Type DEVICE

No Acupuncture Group

This involves not receiving the acupuncture treatment and surgery going entirely as normal according to the hospital's standard of care.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ASA status of 1 or 2
* Ages 18-80
* Undergoing a total hip replacement
* Ability to follow study protocol
* English-speaking

Exclusion Criteria

* Non-English speaking
* Chronic opioids use (6 weeks or more)
* Contraindication to neuraxial anesthesia or peripheral nerve block
* Intending to receive general anesthesia
* Contraindication to intra-op protocol
* Implanted cardiac device (i.e. pacemaker)
* Active ear infection
* Non-native ear, previous scarring or surgery
* Ear gauges or other deforming ear piercing
* Allergy to Nickel
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital for Special Surgery, New York

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephanie Cheng, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital for Special Surgery, New York

Locations

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Hospital for Special Surgery

New York, New York, United States

Site Status

Countries

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United States

Other Identifiers

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2021-1496

Identifier Type: -

Identifier Source: org_study_id

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