J Korean Orthop Assoc.  2008 Oct;43(5):638-642. 10.4055/jkoa.2008.43.6.638.

The Effect of Intraoperative Periarticular Local Injection in Total Knee Arthroplasty

• Choi HR
• Park JS
• Lee BI

• KMID: 2186427
• DOI: http://doi.org/10.4055/jkoa.2008.43.6.638

Abstract

PURPOSE: To assess the effect of intraoperative periarticular local injection in total knee arthroplasty.
MATERIALS AND METHODS
We studied 36 patients (72 knees) that underwent bilateral simultaneous primary total knee replacement between October, 2005 and December, 2006. The study group (36 ipsilateral knees) received a 60 ml intraoperative periarticular injection containing a mixture of bupivacaine, epinephrine, morphine, ketorolac, and saline. The injection was made in the posterior capsule and surrounding soft tissues, muscles, and subcutaneous tissues. The control group (36 contralateral knees) did not receive this injection. Postoperative pain levels were evaluated at 2, 8, 24, 48, and 72 hours and 7 and 14 days using the Visual Analogue Scale (VAS). Hemo-vac drains were evaluated at postoperative days 1, 2, 3, 4, and 5.
RESULTS
There was no side-to-side difference of VAS in both the study group and the control group according to the side chosen. Preoperative VAS was not significantly different between the two groups. There was a significant decrease in the VAS of the study group patients at 2, 8, 24, 48, and 72 hours postoperative, with the most significant decrease seen at 2 hours. Postoperative bleeding was significantly lower in the study group on the first day, with no difference seen thereafter between the two groups.
CONCLUSION
Intraoperative periarticular local injection provides better immediate postoperative pain control in total knee arthroplasty.

Keyword

Total knee arthroplasty; Pain; VAS; Local injection

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee
Bupivacaine
Epinephrine
Hemorrhage
Humans
Ketorolac
Knee
Morphine
Muscles
Pain, Postoperative
Subcutaneous Tissue
Bupivacaine
Epinephrine
Ketorolac
Morphine

Figure

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  Fig. 1 Bars represent VAS at preoperation and postoperative 2, 8, 24, 48, 72 hours, and 7th, 14th day for each group.

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  Fig. 2 The graph shows the amount of decreased VAS for each group.

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