Tsukada S. J Bone Joint Surg Am. 2014. doi:10.2106/JBJS.M.01098.
Periarticular injection offered better postoperative pain relief, earlier recovery of knee flexion angle and lower incidence of nausea compared with epidural analgesia among patients who underwent total knee arthroplasty, according to study results.
Researchers randomly assigned 111 patients undergoing total knee arthroplasty (TKA) to periarticular injection or epidural analgesia groups. All patients were managed with spinal anesthesia, and the surgical technique and postoperative medication protocol were identical for both groups.
The study’s primary outcome measure was postoperative pain at rest, which the researchers quantified as the area under the curve of VAS pain scores to 72 hours postoperatively.
Results from the intention-to-treat analysis showed a significantly lower area under the curve for pain score at rest among the periarticular injection group, according to the researchers.
Compared with the epidural analgesia group, the periarticular injection group had a small, but significantly better, postoperative day 1 and postoperative day 2 mean knee flexion angle. The researchers also found a significantly lower incidence of nausea at postoperative day 1 in the periarticular injection group.
According to study results, transient peroneal nerve palsy was frequently seen in the periarticular injection group.
Disclosure: The authors have no relevant financial disclosures.
