Letter re: Reply: Letter to editor: Superior analgesic efficacy of preemptive low-dose ketorolac compared with parecoxib after total knee arthroplasty: A retrospective propensity score matching study

Thank you for forwarding the insightful comments on our manuscript, “Superior Analgesic Efficacy of Preemptive Low-Dose Ketorolac compared with Parecoxib after Total Knee Arthroplasty: A Retrospective Propensity Score Matching Study.”

We appreciate the acknowledgment of our work and are encouraged by the constructive feedback provided by the authors. We concur that incorporating the EuroQol-5D (EQ-5D-5 L) in conjunction with the visual numeric rating scale could offer a more comprehensive understanding of patient outcomes, particularly beyond the initial 48 hours postoperatively. We recognize the importance of long-term assessments and improved quality of life measures, and we intend to explore these dimensions in future investigations.

The individual variability in pain perception, influenced by genetic and environmental factors, is indeed a critical aspect that may impact the outcomes of our study. We acknowledge the recommendation by Nielsen et al. regarding the use of stimulus-response functions for measuring pain sensitivity.^1,2 While this was not part of our routine practice, it represents an additional limitation that we acknowledge in our study.

Regarding the physiotherapy regimen, we appreciate the opportunity to clarify that the protocol was consistent across both groups, involving the application of cold packs on the operated knee for 20 minutes per hour, with no other interventions.

We value the constructive suggestions provided, as they not only contribute to the refinement of our current work but also offer insights for future research endeavors in the field of pain control post total knee arthroplasty. We are committed to addressing these considerations in our ongoing and future research, aiming for continuous improvement.