A state-of-the-art pain protocol for total knee replacement

Total knee replacement is acknowledged as a successful and durable operation, but recovery from this surgery is often lengthy and painful. A great deal of attention has recently been directed at enhancing this recovery, most of which has focused on improvements in perioperative pain control. Various protocols have been suggested. This article discusses a pain management program that uses local infiltrative analgesia with a specific "cocktail" which, when combined with an oral multimodal pain regimen, has led to excellent patient satisfaction and a substantially shorter length of stay.