Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled Study

J Arthroplasty. 2017 Sep;32(9S):S268-S271. doi: 10.1016/j.arth.2017.03.062. Epub 2017 Apr 6.


Background: We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control.

Methods: This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, visual analog pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded.

Results: There was no significant difference between the two groups (control N = 49, experiment N = 47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or visual analog score for pain postoperatively.

Conclusion: There is no benefit in the use of liposomal bupivacaine compared with ropivacaine for postoperative pain control in TKA.

Trial registration: ClinicalTrials.gov NCT02808728.

Keywords: liposomal bupivacaine; osteoarthritis; pain management; total knee arthroplasty; total knee replacement.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Amides / administration & dosage
  • Anesthetics, Local / administration & dosage*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Body Mass Index
  • Bupivacaine / administration & dosage*
  • Double-Blind Method
  • Epinephrine / administration & dosage
  • Female
  • Humans
  • Injections, Intra-Articular / methods
  • Ketorolac / administration & dosage
  • Length of Stay
  • Liposomes / administration & dosage*
  • Male
  • Middle Aged
  • Morphine / administration & dosage
  • Narcotics / administration & dosage
  • Pain Management
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Postoperative Period
  • Prospective Studies
  • Ropivacaine


  • Amides
  • Anesthetics, Local
  • Liposomes
  • Narcotics
  • Morphine
  • Ropivacaine
  • Bupivacaine
  • Epinephrine
  • Ketorolac

Associated data

  • ClinicalTrials.gov/NCT02808728