Local infiltration analgesia in primary total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Pain Management

Background:

• Postoperative pain following total knee arthroplasty (TKA) can impede rehabilitation and increase morbidity.
• Local infiltration analgesia (LIA) is a multimodal analgesic technique combining local anesthetics, NSAIDs, and adrenaline to mitigate pain and systemic side effects.

Purpose of the Study:

• To evaluate the efficacy of single-dose intra-operative LIA in primary TKA.
• To assess the impact of LIA on postoperative pain scores and opioid consumption.

Main Methods:

• A single-centre retrospective cohort study included 136 patients undergoing primary TKA.
• Patients received either single-dose LIA intra-operatively or standard care (control group).
• Primary outcomes included pain scores, morphine demand, and consumption; secondary outcomes assessed range of motion, quadriceps power, and length of stay.

Main Results:

• The LIA group demonstrated significantly lower postoperative morphine demand and consumption (POD 1-4).
• Pain scores were reduced in the LIA group from POD 1 to POD 4.
• Improved range of motion and quadriceps power were observed in the LIA group during the early postoperative period.

Conclusions:

• Intra-operative LIA is effective in reducing postoperative pain and opioid requirements after TKA.
• LIA enhances early functional recovery, including range of motion and quadriceps strength.
• The study recommends the use of LIA as an effective strategy for pain management in TKA.