Periarticular multimodal drug injection improves post-operative pain and functional recovery after total knee arthroplasty.

ABSTRACT

BACKGROUND: This study retrospectively compared the clinical benefits of periarticular multimodal drug injection (PMDI) and continuous femoral nerve block (CFNB) after total knee arthroplasty (TKA). METHODS: From 2010 to 2012, 520 primary TKAs were performed, and patients were treated with CFNB or PMDI after surgery. Patients who underwent simultaneous bilateral TKA were excluded, leaving 185 and 166 patients in the CFNB and PMDI groups, respectively. Numeric rating scale for pain (NRS) scores and analgesic consumption were evaluated to compare the effectiveness of pain control between the groups. Further, range of motion (ROM), extension lag, the time to recovery of functions, and postoperative C-reactive protein (CRP) levels were monitored. Complications such as deep infection were assessed. RESULTS: The PMDI group displayed a significantly smaller NRS score on postoperative day (POD) 1 and lower analgesic consumption on PODs 0 and 1. The times to functional recovery were significantly shorter and the extension lag was smaller in the PMDI group. Furthermore, CRP levels were lower in the PMDI group by POD 7. No obvious deep infections were noted. CONCLUSION: Our results indicate that PMDI induced earlier functional recovery after TKA than CFNB, partially via its analgesic effect.