Objective: The purpose of this study was to identify the analgesic effects of the S-flurbiprofen delivered by a topical preparation in the postoperative subacute phase of total knee arthroplasty (TKA).

Method: From June 2017 to July 2018, 60 knees that underwent unilateral TKA at our hospital were divided into S-flurbiprofen patch group (30 knees) and non-patch group (30 knees), respectively. Loxoprofen 180 mg three times daily was administered in both groups, and acetaminophen 2,400 mg was administered from the day after surgery to the 5th postoperative day. In the S-flurbiprofen patch group, and after the 6th postoperative day, two 40 mg S-flurbiprofen patches were applied to the medial and lateral side of the knee until the 12th postoperative day. There were no active drug group. This is one of limitation. All patients used additional non-steroidal anti inflammatory drugs (NSAIDs) including loxoprofen tablets and diclofenac suppositories at the time of experiencing pain and for the entire period. We compared the number of users of additional NSAIDs for ambulation and for rest pain (pain visual analog scale (VAS)) and Japan Orthopaedic Association score in both groups after the 6th postoperative day.

Results: From the 6th to the 12^th postoperative day, seven patients used additional NSAIDs in the patch group and 15 patients used it in the non-patch group, respectively. Although there were no significant differences between the two groups in the median of pain VAS, in the patch group it tended to be lower after the 6th day than non-patch group.

Conclusion: We consider that the analgesic effects of S-flurbiprofen patches in the subacute phase after TKA surgery reduced the additional use of oral or rectal NSAIDs. Such patches may be effective for subacute phase pain management after TKA.