title: Periarticular multimodal drug injection improves post-operative pain and functional recovery after total knee arthroplasty.
abstract: BACKGROUND
  This study retrospectively compared the clinical benefits of periarticular multimodal drug injection (PMDI) and continuous femoral nerve block (CFNB) after total knee arthroplasty (TKA).
  
  
  METHODS
  From 2010 to 2012, 520 primary TKAs were performed, and patients were treated with CFNB or PMDI after surgery. Patients who underwent simultaneous bilateral TKA were excluded, leaving 185 and 166 patients in the CFNB and PMDI groups, respectively. Numeric rating scale for pain (NRS) scores and analgesic consumption were evaluated to compare the effectiveness of pain control between the groups. Further, range of motion (ROM), extension lag, the time to recovery of functions, and postoperative C-reactive protein (CRP) levels were monitored. Complications such as deep infection were assessed.
  
  
  RESULTS
  The PMDI group displayed a significantly smaller NRS score on postoperative day (POD) 1 and lower analgesic consumption on PODs 0 and 1. The times to functional recovery were significantly shorter and the extension lag was smaller in the PMDI group. Furthermore, CRP levels were lower in the PMDI group by POD 7. No obvious deep infections were noted.
  
  
  CONCLUSIONS
  Our results indicate that PMDI induced earlier functional recovery after TKA than CFNB, partially via its analgesic effect.
authors.affiliation: Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, Kobe 657-0068, Japan. Electronic address: wavedreamer17@yahoo.co.jp.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, Kobe 657-0068, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Shibanuma
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopaedic Surgery, Chibune General Hospital, Osaka, Japan.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Tei
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kuroda
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D005267:Femoral Nerve; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics