Analgesia after ACL reconstruction: Hamstring donor-site injection versus intra-articular local anaesthetic injection

Sonnery‐Cottet, Bertrand; Saithna, Adnan; Azeem, Abdul; Choudja, Eric; Pic, Jean-Baptiste; Cabaton, J.; Thaunat, Mathieu

doi:10.1016/j.otsr.2016.11.011

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…Previous research has demonstrated the efficacy of local anesthesia. 9 , 10 , 11 However, the use of anesthetic cocktails containing a combination of drugs for local injection during arthroplasty procedures has shown promising results in further reducing postoperative pain. 12 , 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

“… 17 , 18 , 19 , 20 In addition, injecting local anesthetic cocktails into the hamstrings harvest tract may effectively reduce postoperative pain and alleviate posterior thigh discomfort. 9 , 10 , 11 , 12 , 13 , 14 However, this technique does have some disadvantages, including the requirement for skilled surgeons to perform remnant-preserving ACL reconstruction, an increase in operative time, and the potential for some patients to experience allergies to the local anesthetic cocktail. Advantages and disadvantages of the procedure are further described in Table 1 .…”

Section: Discussionmentioning

confidence: 99%

“… 7 , 8 The studies have demonstrated that administering a local anesthetic injection at the hamstring donor site is more effective than a placebo in relieving postoperative pain and reducing opioid consumption. 9 , 10 , 11 Several studies have reported the use of the anesthetic cocktail in periarticular injections during total knee-replacement surgery. 12 , 13 , 14 The findings consistently demonstrate a reduction in postoperative pain and opioid consumption.…”

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confidence: 99%

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A Technique for Hamstring Donor-Site Injection With Anesthetic Cocktail in Remnant-Preserving Anterior Cruciate Ligament Reconstruction

Thamrongskulsiri,

Chancharoenchai,

Limskul

et al. 2024

Arthroscopy Techniques

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Technique for Hamstring Donor-Site Injection With Anesthetic Cocktail in Remnant-Preserving Anterior Cruciate Ligament Reconstruction

Thamrongskulsiri,

Chancharoenchai,

Limskul

et al. 2024

Arthroscopy Techniques

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“…Multimodal analgesia employs drugs that act by different mechanisms on separate pathways to reduce nociception 16 . Commonly, multimodal analgesia includes a local anesthetic injection [17][18][19] or a regional anesthetic blockade [20][21][22][23] . Collectively, these strategies aim to improve postoperative pain control and facilitate patient mobility compared with traditional opiate-based methods 6,7 .…”

Section: Discussionmentioning

confidence: 99%

Effects of General Anesthesia Plus Multimodal Analgesia on Immediate Perioperative Outcomes of Hamstring Tendon Autograft ACL Reconstruction

et al. 2023

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Background:Anterior cruciate ligament reconstruction with hamstring tendon autograft (H-ACLR) is a standard ambulatory procedure with the potential for considerable postoperative pain. We hypothesized that general anesthesia combined with a multimodal analgesia regimen would reduce postoperative opioid use associated with H-ACLR.Methods:This study was a single-center, surgeon-stratified, double-blinded, placebo-controlled, randomized clinical trial. The primary end point was the total postoperative opioid use during the immediate postoperative period, and secondary outcomes included postoperative knee pain, adverse events, and ambulatory discharge efficiency.Results:One hundred and twelve subjects, 18 to 52 years of age, were randomized to placebo (57 subjects) or combination multimodal analgesia (MA) (55 subjects). The MA group required fewer opioids postoperatively (mean ± standard deviation, 9.81 ± 7.58 versus 13.88 ± 8.49 morphine milligram equivalents; p = 0.010; effect size = −0.51). Similarly, the MA group required fewer opioids within the first 24 hours postoperatively (mean ± standard deviation, 16.56 ± 10.77 versus 22.13 ± 10.66 morphine milligram equivalents; p = 0.008; effect size = −0.52). The subjects in the MA group reported lower posteromedial knee pain (median [interquartile range, IQR]: 3.0 [0.0 to 5.0] versus 4.0 [2.0 to 5.0]; p = 0.027) at 1 hour postoperatively. Nausea medication was required for 10.5% of the subjects receiving the placebo versus 14.5% of the subjects receiving MA (p = 0.577). Pruritis was reported for 17.5% of subjects receiving the placebo versus 14.5% receiving MA (p = 0.798). The median time to discharge was 177 minutes (IQR, 150.5 to 201.0 minutes) for subjects receiving placebo versus 188 minutes (IQR, 160.0 to 222.0 minutes) for those receiving MA (p = 0.271).Conclusions:A combination of general anesthesia and local, regional, oral, and intravenous multimodal analgesia appears to reduce postoperative opioid requirements after H-ACLR compared with placebo. Adding preoperative patient education and focusing on donor-site analgesia may maximize perioperative outcomes.Level of Evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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“…Intra-articular applications can be done to control postoperative pain and it is also applied to support reconstruction. 24,25 Tunnel widening and late healing of tendon-bone are some of the complications after ACL reconstruction. Other Abbreviations: DB, double bundle; SB, single bundle.…”

Section: Discussionmentioning

confidence: 99%

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Yücens

Aydemir

2018

J Knee Surg

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Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the , followed by the, , at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction.

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Analgesia after ACL reconstruction: Hamstring donor-site injection versus intra-articular local anaesthetic injection

Abstract: III, prospective case-control study.

Cited by 5 publications

References 16 publications

A Technique for Hamstring Donor-Site Injection With Anesthetic Cocktail in Remnant-Preserving Anterior Cruciate Ligament Reconstruction

A Technique for Hamstring Donor-Site Injection With Anesthetic Cocktail in Remnant-Preserving Anterior Cruciate Ligament Reconstruction

Effects of General Anesthesia Plus Multimodal Analgesia on Immediate Perioperative Outcomes of Hamstring Tendon Autograft ACL Reconstruction

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

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