Background Pain control after total knee replacement (TKR) is pivotal in postoperative rehabilitation. Usage of epidural analgesia or parenteral opioids can cause undesirable side effects hampering early recovery and rehabilitation. These side effects can be avoided by infiltration of an analgesic cocktail locally. Our study was performed to evaluate the benefits of a particular cocktail combination in patients undergoing TKR with respect to pain and knee motion recovery. Methods One hundred consecutive patients who underwent simultaneous bilateral TKR were enrolled and received an intraoperative periarticular cocktail injection in the right knee (intervention) and normal saline in the left knee (control). Postoperative pain was recorded using the visual analog scale for each knee, and the time taken to achieve 90° of knee flexion was noted for each side. Results The cocktail injected knee had significantly less pain when compared with the control knee during the first 48 hours and significantly shorter period to achieve 90° of knee flexion. Conclusions The use of intraoperative periarticular cocktail injection significantly reduces early postoperative pain and provides better early knee motion.
Implants used for total knee replacement (TKR) in most Asian countries are not designed originally for the Asian population, and studies have shown anthropometric differences with respect to TKR among various ethnic groups. For this reason, implants designed for a specific population may not provide an anatomic fit when used in other populations. To avoid the consequences associated with such a misfit, the concept of ethnic-specific implant design is being introduced. In this study, the knee anthropometry of the Indian and Arabian patients was compared. They were operated with implants which were not ethnic-specific designs. Since the consequences associated with implant misfit apply equally to both the Indian and Arabian population, it is essential to compare the knee anthropometry of these two populations. Anthropometric measurements of the distal femur and proximal tibia of the Indian and Arabian knees were obtained intraoperatively using a Vernier caliper. Their respective aspect ratios (ARs) were calculated and statistically compared. It was found that the ARs of both tibia and femur of Indian and Arabian population did not show any statistical difference. There was no statistical difference between Indian and Arabian males (p = 0.345) and between Indian and Arabian females (p = 0.8210). However, a statistical difference in tibial AR (p-value = 0.049) and femoral AR (p-value = 0.003) was found significant when a comparison was made between the knees of Indian males and Indian females in the study. The above results suggested that TKR implants designed anatomically to suit the Indian population can also suit the Arabian population and vice versa. The obtained data can help implant designers to come up with ethnic-specific TKR implants.
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