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Reducing costly falls after total knee arthroplasty.

Surajudeen Adebola Bolarinwa1, Wendy Novicoff2, Quanjun Cui2

  • 1Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA 22903, United States. sb3dv@hscmail.mcc.virginia.edu.

World Journal of Orthopedics
|October 27, 2018
PubMed
Summary

Adductor canal nerve block (ACB) significantly reduces patient falls after total knee arthroplasty (TKA) compared to femoral nerve block (FNB). ACB is recommended for TKA patients to improve safety and reduce fall incidence.

Keywords:
Adductor canal nerve blockCostly fallsFemoral nerve blockReducing fallsTotal knee arthroplasty

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Area of Science:

  • Orthopedics
  • Anesthesiology
  • Geriatric Medicine

Background:

  • Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
  • Post-TKA falls pose a significant risk to patient recovery and safety.
  • Effective pain management strategies are crucial for minimizing TKA complications.

Purpose of the Study:

  • To compare the incidence of patient falls after TKA between adductor canal nerve block (ACB) and femoral nerve block (FNB).
  • To evaluate the safety and efficacy of ACB as an analgesic option for TKA patients.
  • To identify factors influencing fall rates in the post-TKA population.

Main Methods:

  • Retrospective institutional review of TKA patients from January 2013 to August 2016.
  • Inclusion criteria: primary unilateral TKA for knee osteoarthritis with either FNB or ACB, and a fall during hospitalization.
  • Exclusion criteria: revision TKA, extensor mechanism reconstruction, and pre-existing neurological or lower extremity conditions.

Main Results:

  • A total of 1625 patients were analyzed (834 FNB, 791 ACB).
  • The fall rate was significantly lower in the ACB group (0.13%) compared to the FNB group (1.3%) (P = 0.006).
  • Most falls occurred in patients who underwent right TKA (11/12) and in female patients (9/12).

Conclusions:

  • Adductor canal nerve block (ACB) demonstrates a significant reduction in patient falls post-TKA.
  • ACB should be considered the preferred analgesic technique for TKA to enhance patient safety.
  • Further research may explore specific patient demographics or surgical factors influencing fall risk.