The Journal of arthroplasty
-
Randomized Controlled Trial Clinical Trial
Bupivacaine bolus injection versus placebo for pain management following total knee arthroplasty.
Following surgery, total knee arthroplasty (TKA) patients experience considerable pain. All available effective analgesia agents produce some unwanted side effects. Sixty consenting elective TKA patients were randomized to receive bupivacaine 20 mL 0.5% (100 mg) or 20 mL normal saline injected into the joint space after capsule closure. ⋯ Narcotic usage was recorded. The bupivacaine group had lower pain scores and reduced narcotics during the 24-hour period, with a 23-minute shorter time to discharge from the postanesthesia care unit than the placebo group (P =.02). Although a bupivacaine bolus injected at capsule closure results in decreased pain levels (P =.07) and narcotic consumption (P =.09), it is not statistically significantly better than placebo.
-
Randomized Controlled Trial Clinical Trial
Functional comparison of posterior cruciate-retaining versus posterior stabilized total knee arthroplasty.
A prospective, randomized comparison of posterior cruciate-retaining (PCR) and posterior stabilized (PS) total knee arthroplasties (TKAs) was conducted in 20 patients who underwent bilateral TKAs for osteoarthritis. All procedures were performed by a single surgeon. One knee was implanted with a PCR TKA, and a contralateral knee with a PS TKA. ⋯ Patients had a clinical and radiographic evaluation at a mean of 31.7 months for PCR TKAs and 30.6 months for PS TKAs postoperatively. There were no significant differences between the PCR and PS TKAs in postoperative knee scores. However, postoperative improvement in range of motion was significantly superior in the PS group.
-
Randomized Controlled Trial Clinical Trial
Continuous local cooling for pain relief following total hip arthroplasty.
This study is the first to evaluate whether continuous cryotherapy can relieve pain soon after total hip arthroplasty (THA). Patients who had undergone THA for osteoarthritis were divided into 2 prospective, randomized groups: the cryotherapy group was fitted with a computer-controlled cooling device for 4 days, and the control group was not. ⋯ Furthermore, postoperative analgesic use by the cryotherapy group was significantly lower than by the control group. The results of this study support the potential benefit of a cold compressive device for pain reduction during the postoperative recovery of patients undergoing THA.