Fillingham YA, Hannon CP, Roberts KC, et al. - This study was undertaken to investigate the effectiveness and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) in support of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Management. Researchers carried out to search databases including MEDLINE, EMBASE, and the Cochrane Central Registry of Controlled Trials for studies published prior to November 2018 on NSAIDs in total joint arthroplasty (TJA). In this study, 25 articles represented the best available evidence for inclusion in the analysis after a critical appraisal of 2921 publications. The outcomes of this research demonstrate that strong data support the use of an oral selective COX-2 or non-selective NSAID and intravenous ketorolac as adjunctive medications to manage postoperative pain during the hospitalization for TJA. Although no safety concerns were found, prescribers require to remain vigilant when prescribing NSAIDs.