Periarticular regional analgesia in total knee arthroplasty – Efficacy and outcome of single posterior capsular vs multiple site injections

Abstract

ObjectiveTotal knee arthroplasty (TKA) is a frequently performed elective orthopedic intervention for painful arthritic knee with the purpose to improve postoperative quality of life. However, TKA is followed by intense pain in postoperative period. Postoperative pain after total knee arthroplasty (TKA) is a well-known clinical problem and prevents patients from sleeping, ambulating and participation in physical therapy. The infiltration of a cocktail in knee joint is a simple procedure performed by surgeon in soft tissue before component implantation. However, the technique and site of periarticular infiltration is still evolving, recent studies suggest that the proper technique of periarticular injection includes drug administration at eight sites around the knee. The purpose of this study was to compare the efficacy and outcome of single posterior capsule vs multiple site infiltration. MethodsThis was a prospective randomized control study. A total of forty patients were randomly assigned into two groups of twenty each. Group A was given a single periarticular injection of a fixed cocktail just before implantation of components while group B was given same cocktail at eight predetermined sites around knee. Post operatively pain status was assessed by means of visual analogue scale. ResultsComparison of the pain scores of the two group were not statistically significant. ConclusionThe results of the study indicates that periarticular infiltration is a safe and effective means of postoperative pain control and that single posterior capsular infiltration is as effective as multiple infiltration.