Efficacy of intra-operative periarticular local infiltration for pain control and ambulation in total knee arthroplasty

Abstract

Total knee replacement (TKR) is a leading operative procedure for late-stage knee osteoarthritis. Pain, post-replacement hinders an effective rehabilitation protocol. Many preoperative, perioperative, and postoperative analgesia modes have been reported but have some undesirable side effects. To overcome these side effects, an intraoperative local analgesic cocktail can be used. We conducted this study to assess the benefits of intra-operative local infiltration of cocktail in TKR patients in terms of pain, amount of additional analgesia required post-operatively, and ambulation time. 50 patients were chosen and split into two groups of 25 each. The case group received the cocktail injection whereas the control group were injected locally with normal saline. Post-operatively VAS score was assessed at 3, 6,12 and 24 h post-surgery, the amount of analgesics used and ambulation time was assessed. Compared to the control group, the case group had significantly less pain in the first 24 h and a lower amount of additional analgesia and earlier ambulation. Pain reduction with early ambulation was noted in a significant number of individuals with the use of this intraoperative local cocktail injection.