Pain relieve without impairing muscle function after local infiltration anaesthesia in primary knee arthroplasty: a prospective randomized study.
PURPOSE
Purpose of the current study was to compare early effectiveness of pain relieve of 3 in 1 regional pain catheter to local infiltration anesthesia (LIA) in primary total knee arthroplasty (TKA). Secondary endpoint was quadriceps muscle strength after both procedures.


MATERIAL AND METHODS
A single-center, prospective, randomized controlled trial was performed. Patients eligible to TKA were either randomized into group 3 in 1 regional pain catheter (C), or group local infiltration anesthesia (L). Pain relieve was assessed by visual analogue scale (VAS) at rest and under physical activity (PA) prior to surgery (t0) and at days one through six. In addition, quadriceps muscle strength ( = straight leg raise) was tested according to the Manual Muscle Testing Scale. Functional outcome was measured using the Oxford Knee Score (OKS) preoperatively and 6 months postoperatively.


RESULTS
121 patients were included in the study. 59 (48.8%) patients were allocated to group C, 62 (51.2%) patients to Group L. No differences concerning pain level evaluated by VAS could be detected between the groups at any time. Comparing straight leg raise test group L was significantly superior over the complete postoperative period (p < 0.03). The mean OKS decreased significantly (p < 0.001) from preoperatively 34.2 ± 7.5 points to 16.9 ± 6.0 points at the six months final follow-up. Regarding OKS there were no intergroup differences at the final follow-up at 6 months postoperative.


CONCLUSION
There is no significant difference in pain relieve comparing LIA to 3 in 1 catheter in perioperative pain management in TKA. The advantage of LIA is unimpaired quadriceps muscle function in the short-term follow-up.
['Mayr|H O|HO|', 'Prall|W C|WC|', 'Haasters|F|F|', 'Baumbach|S F|SF|', 'Hube|R|R|', 'Stoehr|Amelie|A|http://orcid.org/0000-0003-3424-1120']
D000368:Aged D000772:Anesthesia, Local D019645:Arthroplasty, Replacement, Knee D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D059408:Pain Management D010147:Pain Measurement D010149:Pain, Postoperative D020127:Recovery of Function D016896:Treatment Outcome
Local infiltration anesthesia TKA Oxford knee score 3 in 1 catheter Pain management Quadriceps muscle function