Pelubiprofen is comparable to celecoxib for postoperative pain control after total knee arthroplasty: a randomized pilot trial

Background Effective postoperative pain control is essential to facilitate early recovery after total knee arthroplasty (TKA), particularly within enhanced recovery pathways. Celecoxib, a selective cyclooxygenase‑2 inhibitor, is widely used as part of multimodal analgesia after TKA, whereas clinical data on pelubiprofen tromethamine remain limited. This pilot study aimed to compare postoperative analgesic efficacy and early functional recovery between pelubiprofen and celecoxib after primary TKA. Methods This randomized pilot study included patients undergoing primary TKA who received perioperative pelubiprofen or celecoxib according to the study protocol. Postoperative pain intensity was assessed using a 100‑mm visual analog scale (VAS). Early functional recovery was evaluated using knee range of motion (ROM), and patient satisfaction was assessed using a 100‑mm VAS on postoperative day (POD) 7. The frequency of rescue analgesic use during the early postoperative period was recorded and compared between groups. Results A total of 100 patients were analyzed, with 50 in each group. The mean VAS score on POD 2 was 37.0 ± 12.2 in the celecoxib group and 36.8 ± 11.0 in the pelubiprofen group (p = 0.931). No significant differences in VAS scores were observed between groups on POD 1 or POD 7. Knee ROM at POD 7 was similar between the celecoxib and pelubiprofen groups (119.4 ± 11.1° vs. 117.2 ± 11.4°, p = 0.328). Patient satisfaction scores at POD 7 were also comparable (83.6 ± 4.8 vs. 84.4 ± 5.0 on a 100‑mm VAS, p = 0.412). The mean frequency of rescue analgesic use did not differ significantly between the celecoxib and pelubiprofen groups (8.6 ± 4.9 vs. 8.9 ± 4.6 administrations, p = 0.764). Conclusions This randomized pilot study demonstrated that perioperative pelubiprofen provided postoperative pain control comparable to celecoxib after primary TKA, with similar early functional recovery, patient satisfaction, and rescue analgesic use. These findings suggest that pelubiprofen could serve as a feasible alternative analgesic option in multimodal pain management after TKA. Trial registration. Clinical Research Information Service (CRIS), TRN: KCT0011481, Registration date: 16/01/2026.