The AAHKS Clinical Research Award: Liposomal Bupivacaine and Periarticular Injection Are Not Superior to Single-Shot Intra-articular Injection for Pain Control in Total Knee Arthroplasty.
Intraoperative injections can help reduce early postoperative pain in total knee arthroplasty. We proposed that liposomal bupivacaine would not be superior to more common and cheaper injections.



A single-blinded prospective randomized study with 207 consecutive patients was completed. Patients were randomized to treatment with periarticular liposomal bupivacaine injection, periarticular injection of bupivacaine/morphine, or intra-articular injection of bupivacaine/morphine at the conclusion of the procedure. Postoperative visual analog pain scores and narcotic consumption were recorded and analyzed.



There was no significant difference in postoperative visual analog pain scores or narcotic consumption among the 3 study groups.



Intra-articular injection of bupivacaine and morphine is as effective for postoperative pain control in total knee arthroplasty as periarticular bupivacaine/morphine injection and liposomal bupivacaine. Use of liposomal bupivacaine in total knee arthroplasty is costly and not justified.
Virtua Joint Replacement Institute, Voorhees, New Jersey.
Rajesh K
RK
Jain
Virtua Joint Replacement Institute, Voorhees, New Jersey.
Manny D
MD
Porat
Virtua Joint Replacement Institute, Voorhees, New Jersey.
Greg G
GG
Klingenstein
Virtua Joint Replacement Institute, Voorhees, New Jersey.
Jeremy J
JJ
Reid
Virtua Joint Replacement Institute, Voorhees, New Jersey.
Robert E
RE
Post
Virtua Joint Replacement Institute, Voorhees, New Jersey.
Scott D
SD
Schoifet
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001363:Awards and Prizes; D002045:Bupivacaine / Q000008:administration & dosage*; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D007902:Length of Stay; D008081:Liposomes / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D011184:Postoperative Period; D011446:Prospective Studies; D016037:Single-Blind Method
D000779:Anesthetics, Local; D008081:Liposomes; D009020:Morphine; D002045:Bupivacaine; D004837:Epinephrine
intra-articular injection; liposomal bupivacaine; multimodal pain control; periarticular injection; postoperative pain management; total knee arthroplasty