Postoperative pain prevention in patients undergoing total knee arthroplasty Musculoskeletal Diseases
Conditions
Interventions
Group 1 (Placebo): Perioperative soft tissue around the operated knee was infiltrated with 100 ml of 0.9% saline (placebo) at the same five injection sites as the active groups: 1) quadriceps tendon r
2) posterior knee joint capsule (40 ml)
3) Hoffa’s body (10 ml)
4) anterior knee capsule (40 ml)
5) patellar ligament (5 ml). Intraoperative injections administered immediately before implant placement.
Group 2 (Intraoperative Local Infiltration Analgesia, LIA): Intraoperative knee infiltration
5) patellar ligament (5 ml).
Group 3 (Femoral Nerve Block + Intraoperative Saline Infiltration): A femoral nerve block with bupivacaine was performed under the inguinal ligament after the procedure,
Sponsors
Centrum Medycznego Ksztalcenia Podyplomowego
Eligibility
Sex/Gender
All
Age
60 Years to 90 Years
Inclusion criteria
Inclusion criteria: 1. Patients scheduled for primary total knee arthroplasty (TKA) due to idiopathic degenerative changes of the knee. 2. Kellgren–Lawrence grade II–III degeneration in the affected knee. 3. Written informed consent provided after comprehensive explanation of the study procedures and aims. 4. Eligibility to receive the specified prosthesis (PS Triathlon, Stryker) as part of the planned TKA procedure. 5. Age range: 60-90 years old
Exclusion criteria
Exclusion criteria: 1. Secondary degenerative changes due to chronic inflammatory diseases (e.g., rheumatoid arthritis, psoriatic arthritis) 2. Degenerative changes of post-infectious or post-traumatic origin 3. Prior surgeries around the knee (e.g., peri-knee osteotomies) Candidates for knee revision arthroplasty 4. Requirement for simultaneous correction of large axial deformities (varus/valgus): valgus > 15°, varus > 10° 5. Massive preoperative motion disorders: flexion contracture > 10°, extension contracture 35 kg/m² 6. Allergy to any drugs used in the study 7. Failure to sign informed consent 8. Intraoperative complications (e.g., ligament injuries, peri-prosthetic fractures, common peroneal nerve palsy) 9. Early postoperative complications (e.g., deep vein thrombosis, pulmonary embolism, early prosthetic infection)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total amount of additional opioid analgesics required (converted to morphine equivalents) during the five-day postoperative observation measured using patient records | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Pain using the Visual Analog Scale (VAS) in the five groups over the five-day postoperative period 2. Knee joint function by assessing range of motion (ROM) across the four groups during the five-day postoperative period 3. Postoperative C-reactive protein (CRP) levels between day 3 and day 5 across the four groups | — |
Countries
Poland
Contacts
Public ContactDariusz;Maciej Grzelecki;Kocon
;
Outcome results
None listed