A Randomized Clinical Trial Assessing the Efficacy of Periarticular Injection (LIA) during Total Knee Joint Replacement in the Asian Population

Abstract

Introduction: Osteoarthritis patients usually come very late in the natural course often having bilateral involvement of degenerative changes. Patients are counseled and advised for staged procedures, however, after the first knee surgery, due to postoperative pain, the majority of them are reluctant to undergo total knee arthroplasty (TKA) in the other knee. We did a prospective randomized double-blind control study comparing the amount of analgesic required in the immediate postoperative period in those patients who received a periarticular cocktail injection and those who did not, following TKA. Materials and methods: This was a single-center prospective randomized controlled, double-blind, clinical analysis comparing 126 patients receiving intraoperative analgesia cocktail and control group during TKA. Group I (n 72) received local infiltration of analgesic (LIA), group II (n 54) did not receive any injection. Patients were assessed for pain in terms of visual analog scale (VAS) score, postoperative analgesia requirement, and knee range of motion. Results: The mean postoperative Oxford knee score at 2 months of group I was 30.47 (SD 4.45) compared with group II was 30.30 (SD 5.44). There was a significantly lower mean VAS score (3.16) in group I than group II (7.45) and was statistically significant with a p value of 0.0005. At the end of 2 months, both the groups had similar degrees of range of motion. Conclusion: Local infiltration of analgesia during TKA with our combination of drugs effectively reduces postoperative pain and decreased analgesic consumption, without adding much to the cost of the surgery and also significantly improves patient compliance and rehabilitation.