Is intra-articular multimodal drug injection effective in pain management after total knee arthroplasty? A randomized, double-blinded, prospective study

J Arthroplasty. 2011 Oct;26(7):1095-9. doi: 10.1016/j.arth.2011.03.052. Epub 2011 Aug 9.

Abstract

We performed a prospective, double-blinded, randomized, and controlled study to assess the clinical efficacy and safety of intra-articular multimodal drug injection after total knee arthroplasty. Two hundred eighty-six patients undergoing simultaneous bilateral total knee arthroplasty were randomized to receive the injection of multimodal drugs in one knee and normal saline solution as a placebo in the contralateral knee. All patients received patient-controlled analgesia for 48 hours after surgery, followed by standard analgesia. Visual analog scores for pain during activity and rest and for patient satisfaction were recorded. The range of motion and blood loss were also recorded. Intraoperative intra-articular injection of multimodal drugs into the knee did not improve patient pain and satisfaction, range of motion, or blood loss compared with the placebo control.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid / administration & dosage
  • Anesthetics, Local / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Arthroplasty, Replacement, Knee*
  • Bupivacaine / administration & dosage
  • Double-Blind Method
  • Drug Therapy, Combination
  • Epinephrine / administration & dosage
  • Female
  • Humans
  • Injections, Intra-Articular
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / analogs & derivatives
  • Methylprednisolone Acetate
  • Middle Aged
  • Morphine / administration & dosage
  • Osteoarthritis, Knee / surgery
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Patient Satisfaction

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Methylprednisolone Acetate
  • Morphine
  • Methylprednisolone
  • Bupivacaine
  • Epinephrine