Periarticular Injection for Pain Control After Surgical Treatment of Knee Periprosthetic Joint Infection

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Pain Management

Background:

• Periprosthetic joint infection (PJI) is a severe complication following total knee arthroplasty (TKA).
• Treatment for knee PJI often involves complex surgical procedures.
• Periarticular injection (PAI) is used in primary TKA for pain but avoided in PJI due to infection concerns.

Purpose of the Study:

• To evaluate the safety and efficacy of intraoperative PAI in the surgical treatment of knee PJI.
• To assess the impact of PAI on postoperative pain, opioid consumption, and reinfection rates.

Main Methods:

• Retrospective review of 309 patients undergoing surgical treatment for knee PJI (2015-2023).
• Comparison between 121 patients receiving intraoperative PAI and 188 control patients.
• Assessment of pain scores, opioid consumption (MME), and one-year reinfection rates.

Main Results:

• No significant difference in one-year reinfection rates between PAI and control groups (5.0% vs 8.0%, P = 0.30).
• PAI group showed significantly lower pain scores at 24 and 48 hours post-surgery (P < 0.001 and P = 0.042, respectively).
• Patients receiving PAI required less opioid medication (MME) in the first 24 hours (90.2 vs 130.4 MME, P = 0.0036).

Conclusions:

• Intraoperative PAI for knee PJI surgery effectively reduces early postoperative pain and opioid requirements.
• PAI does not increase the risk of reinfection in patients treated for knee PJI.
• PAI is a safe adjunct for optimizing pain control and minimizing opioid exposure in knee PJI treatment.