Multimodal periarticular injection vs continuous femoral nerve block after total knee arthroplasty: a prospective, crossover, randomized clinical trial

J Arthroplasty. 2012 Jun;27(6):1234-8. doi: 10.1016/j.arth.2011.12.021. Epub 2012 Feb 8.


This study compares the efficacy of pain control using continuous femoral nerve block (FNB) and multimodal periarticular soft tissue injection. This is a randomized, crossover, clinical trial. Sixteen patients having bilateral osteoarthritis of the knee scheduled for staged total knee arthroplasty were randomized to receive either FNB (0.2% ropivacaine), via indwelling catheter for 72 hours, or multimodal periarticular soft tissue injection in the first stage. In the second stage, they received the opposite treatment. The primary outcome measure was morphine consumption by patient-controlled analgesia in the first 72 hours postoperatively. Cumulative morphine consumption as well as rest pain and motion pain in the first 72 hours was comparable between the 2 groups. The functional outcomes did not differ significantly. We conclude that multimodal periarticular soft tissue injection provides comparable analgesia to continuous FNB after total knee arthroplasty.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amides / administration & dosage*
  • Amides / therapeutic use*
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Arthroplasty, Replacement, Knee / methods*
  • Catheters, Indwelling
  • Cross-Over Studies
  • Female
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Nerve Block / methods*
  • Osteoarthritis, Knee / surgery*
  • Outcome Assessment, Health Care
  • Pain, Postoperative / prevention & control*
  • Prospective Studies
  • Ropivacaine
  • Treatment Outcome


  • Amides
  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Ropivacaine