Is early rehabilitation after Total Knee Replacement better with periarticular cocktail of injection or epidural Ropivacaine?

Abstract

TKA is routinely done orthopaedic procedure done that aims at improving the quality of patients' life by providing pain relief, functional improvement and deformity correction. This study aims to study the efficacy and safety of a Periarticular analgesic cocktail including ropivacaine injection and epidural ropivacaine for early rehabilitation after a total knee replacement.

Methods: Total of 100 patients divided into two groups, one group received epidural ropivacaine and second group given periarticular cocktail containing ropivacaine. Then postoperatively their pain score comparison using VAS score and their functional status is documented knee society score.

Results: The mean age for the epidural group is 60.28 years, while for the periarticular cocktail group it's 60.88 years. For female patients, 34 (68%) received epidural analgesia, while 24 (48%) received periarticular cocktail. Among male patients, 16 (32%) had epidural analgesia, and 26 (52%) received periarticular cocktail. For pre-operative pain scores, patients receiving Epidural analgesia had a slightly higher mean score of 7.24 compared to those receiving Periarticular Cocktail, who had a mean score of 7.12. Patients in the Epidural group had a higher mean knee flexion of 83.84 degrees compared to the Periarticular Cocktail group, which had a mean flexion of 79.36 degrees. The Knee Society Scores (KSS) for the post-operative scores; The Epidural group had a mean score of 80.16. The Periarticular Cocktail group had a mean score of 88.40.

Conclusion: In conclusion, this study supports the periarticular analgesic cocktail over epidural analgesia for pain management and early rehabilitation following TKR.