Relationship Between Intraarticular Injections on Patient-reported Outcomes in Total Knee Arthroplasty

Area of Science:

• Orthopedics
• Pain Management
• Arthroplasty Surgery

Background:

• Intraarticular (IA) injections are common for patients undergoing total knee arthroplasty (TKA).
• These injections aim to alleviate pain, enhance function, and potentially delay surgical intervention.
• Understanding the comparative effects of different IA injection types is crucial for optimizing patient care.

Purpose of the Study:

• To investigate the relationship between various intraarticular injection types and patient outcomes before and after TKA.
• To compare the efficacy of ketorolac, triamcinolone, and no injection in managing preoperative and postoperative symptoms.

Main Methods:

• A retrospective review of 321 patients undergoing primary TKA between 2016 and 2022.
• Patients were classified based on IA injection type received within six months of TKA: ketorolac, triamcinolone, or no injection.
• Outcomes assessed included the Knee Injury and Osteoarthritis Outcome Score (KOOS) and opioid prescription data.

Main Results:

• Significant differences in preoperative KOOS pain and activities of daily living (ADL) scores were observed among the groups.
• Triamcinolone injections were linked to reduced preoperative pain and improved function compared to ketorolac.
• No significant differences in KOOS subscales or opioid prescriptions were found at 3 months post-TKA between the injection groups.

Conclusions:

• Triamcinolone IA injections demonstrated superior preoperative pain relief and functional improvement compared to ketorolac before TKA.
• Further prospective research, stratified by osteoarthritis severity, is recommended to evaluate the risk-benefit profile of IA injections.
• Investigating the impact of IA injections on osteoarthritis progression and disease heterogeneity is warranted.