Efficacy of intra-articular cocktail analgesic injection in total knee arthroplasty — A randomized controlled trial

Fu, Peiliang; Wu, Yuli; Wu, Haishan; Li, Xiaohua; Qian, Qirong; YunLi, Zhu

doi:10.1016/j.knee.2008.12.012

Cited by 118 publications

(119 citation statements)

References 18 publications

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“…374 Twenty-three studies were in patients undergoing TKR. 380,381,386,[397][398][399][400][401][402][403][404][405][406][407][408][409][410][411][412][413][414] Small study effects Inspection of funnel plots for each meta-analysis gave no strong indication of publication bias or small study effects, but numbers of studies in individual analysis groups were small, such that assessment of asymmetry was difficult.…”

Section: Resultsmentioning

confidence: 99%

“…The mean number of patients randomised was 63 (range 32-101). We assessed that 17 studies were at low risk of bias 386,[399][400][401][402][403][404][405][406][407][408][409][411][412][413] and that five studies had unclear risk of bias based on uncertainty about blinding of outcome assessments. 380,397,398,410,414 One study was assessed to be at high risk of bias owing to a large uneven loss to follow-up between randomised groups.…”

Section: Long-term Outcomesmentioning

confidence: 99%

“…401,[404][405][406]414 As shown in Table 37 and Figure 25, pain at 24 hours was reduced both at rest and during activity [SMDs -0.25 (95% CI -0.45 to -0.04; p = 0.017) and -0.28 (95% CI -0.47 to -0.10; p = 0.003), respectively]. In six trials where additional analgesia was delivered through a catheter or as an injection after wound closure (B group), 398,402,403,412,413 reduction in pain at 24 hours was somewhat greater than controls at both rest and activity [SMDs -0.59 (95% CI -0.83 to -0.35; p < 0.001) and -0.69 (95% CI -1.15 to -0.23; p = 0.003)].…”

Section: Painmentioning

confidence: 99%

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Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

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Section: Resultsmentioning

confidence: 99%

Section: Long-term Outcomesmentioning

confidence: 99%

Section: Painmentioning

confidence: 99%

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Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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“…1 More than two third of the patients report moderate to severe pain in the immediate post-operative period which is a cause of dissatisfaction. 2 Postoperative pain has also been considered as an indirect cause of complications such as pneumonia and deep vein thrombosis. 3 A battery of pain management techniques are available including femoral nerve block (FNB), patient controlled analgesia (PCA), epidural analgesia, with or without sciatic nerve block, and multimodal periarticular cocktail injection (MPCI).…”

Section: Introductionmentioning

confidence: 99%

“…1,4 Results from recent studies show that using the method of MPCI with a low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug (NSAID) or steroids have shown good pain control and improvement in range of motion after surgery. 1,2,5,6 There has been concern regarding an increased risk of post-operative infection and tendon rupture after periarticular injection of steroid. [7][8][9] We have designed this study as a prospective, doubleblinded, randomized controlled trial to compare the efficacy of pain control after TKA, using MPCI with steroid or without steroid.…”

Section: Introductionmentioning

confidence: 99%

Multimodal periarticular cocktail injection using steroid in total knee arthroplasty: a double blind randomised trial

et al. 2017

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Background: Multimodal periarticular cocktail injection (MPCI) containing local anesthetics, adrenaline, and anti-inflammatory agents such as NSAIDS have been promising in terms of quick functional recovery. This study evaluates the efficiency of steroid as a component of MPCI in knee arthroplasty.Methods: This is a prospective, double-blind, RCT where 36 patients with osteoarthritis were included and randomized to receive MPCI either with steroid or without steroid. Pain was evaluated by visual analogue scale (VAS) at preoperative and postoperatively at rest, and during activity. The range of motion of the knee was looked for in a similar way. The amount of NSAIDs and the duration of NSAID usage were noted till the last follow-up.Results: Both non-steroid and steroid groups were similar with regard to VAS at rest and during activity, or range of motion, at all postoperative observations. The postoperative knee society knee score in the steroid group improved significantly as compared to that in non-steroid group at the one-month (84.1±13.1 and 65.9±12.1; p<0.0045) and three-month follow-up (90.2±16.3 and 72.5±16.6; p<0.0027), but no significant difference was noted at six-month follow up. There was no significant difference in consumption of NSAIDs within 72 hours between the two groups. The duration of piroxicam usage in patients in the steroid group was significantly shorter than that in the non-steroid group, (7.2±0.7) compared with (10.5±1.9) weeks; =0.012.Conclusions: The Study validates usage of steroid in MPCI due to faster rehabilitation and less consumption of NSAIDs and no additional risk of post-operative complications.

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Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

Weibel

Rücker

Eberhart

et al. 2020

Cochrane Database of Systematic Reviews

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Efficacy of intra-articular cocktail analgesic injection in total knee arthroplasty — A randomized controlled trial

Cited by 118 publications

References 18 publications

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Multimodal periarticular cocktail injection using steroid in total knee arthroplasty: a double blind randomised trial

Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

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