title: Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: a prospective randomized study.
abstract: In this prospective randomized study, patients undergoing total hip (THA) or knee arthroplasty (TKA) were randomized to either a study group receiving periarticular injections or a control group receiving patient-controlled analgesia with or without femoral nerve block (TKA patients). All patients received a comprehensive multimodal perioperative protocol. Pain, recovery of functional milestones, and overall satisfaction were assessed. The THA study group demonstrated significantly lower average pain scores and higher overall satisfaction than the control group. There was no significant difference in pain scores between the study and control groups in the TKA cohort. Both study groups demonstrated lower narcotic usage and side effects as well as improved early functional recovery. Periarticular injection with a multimodal protocol was shown to safely provide excellent pain control and functional recovery and can be substituted for conventional pain control modalities.
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Hari K
authors.initials: HK
authors.lastname: Parvataneni
authors.forename: Vineet P
authors.initials: VP
authors.lastname: Shah
authors.forename: Holly
authors.initials: H
authors.lastname: Howard
authors.forename: Naida
authors.initials: N
authors.lastname: Cole
authors.forename: Amar S
authors.initials: AS
authors.lastname: Ranawat
authors.forename: Chitranjan S
authors.initials: CS
authors.lastname: Ranawat
mesh_terms: D000698:Analgesia / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011446:Prospective Studies