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Local infiltration analgesia with additional intraarticular catheter provide better pain relief compared to single-shot local infiltration analgesia in TKA

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Local infiltration analgesia (LIA) has been proven to be efficient in total knee arthroplasty (TKA). However, the effect of single-shot LIA is temporarily limited. The objective of this prospective trial was to investigate if the potential benefits resulting from LIA can be prolonged by a continuous intra-articular perfusion of LIA. The hypothesis of the present study was that the use of an additional continuous intra-articular perfusion delivering LIA would result in less pain and better function compared to single-shot LIA in the immediate post-operative period.

Methods

50 consecutively selected patients undergoing TKA received either a single-shot LIA (S-LIA group, 25 knees) or single-shot LIA combined with a continuous post-operative intra-articular perfusion for three post-operative days (CP-LIA group, 25 knees). VAS (visual analogue scale) for pain, pain medication consumption and flexion ability were recorded postoperatively for 6 days. All patients had the same implant, surgeon and intra- as well as post-operative setting.

Results

The VAS score was significantly better for CP-LIA 6 h after surgery and on post-operative day 1, 2 and 6. There was no significant difference with regard to additional opioid consumption or flexion ability of the knee. However, there was a trend of the CP-LIA group requiring less additional opioids over the complete post-operative period compared to the S-LIA group. There were no complications or revisions.

Conclusion

LIA combined with an additional intra-articular catheter provides better short-term pain control compared to single-shot LIA. However, no significant differences in terms of knee flexion were observed. This limited benefit should be balanced against the additional costs and the possible higher risk of infection.

Level of evidence

Level II.

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Abbreviations

TKA:

Total knee arthroplasty

LIA:

Local infiltration analgesia

CP-LIA:

Continuous-perfusion local infiltration analgesia

S-LIA:

Single-shot local infiltration analgesia

ROM:

Range of motion

VAS:

Visual analogue scale

LMWH:

Low-molecular-weight heparins

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Funding

No funding was received for the present study.

Author information

Author notes

  1. Malin Meier and Sarah Sommer authors share co-first authorship.

Authors and Affiliations

  1. Sportklinik Stuttgart Taubenheimstr. 8, 70372, Stuttgart, Germany

    Malin Meier, Sarah Sommer, Jochen Huth, Christian Benignus & Johannes Beckmann

  2. Cliniques Universitaires Saint-Luc, Bruxelles, Belgium

    Emmanuel Thienpont

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  1. Malin Meier
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  2. Sarah Sommer
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Corresponding author

Correspondence to Malin Meier.

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Conflict of interest

The authors MM, SS, JH, CB declare that they have no conflict of interest. The author ET declares that he is providing consultancies for Convatec, KCI, LIMA, Medacta and Zimmer Biomet. He also declares that he receives royalties from LIMA, Medacta and Zimmer Biomet. He further declares that he is part of the euopean knee society board. The author JB declares that he has no conflict of interest, receives honoraria from DePuy, Conformis, Pajunk and Smith and Nephew.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the ethic committee of the local state medical council (Approv.No. F-2017-024).

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Informed consent was obtained from all individual participants included in this study.

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Meier, M., Sommer, S., Huth, J. et al. Local infiltration analgesia with additional intraarticular catheter provide better pain relief compared to single-shot local infiltration analgesia in TKA. Arch Orthop Trauma Surg 141, 105–111 (2021). https://doi.org/10.1007/s00402-020-03606-0

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