Pain Control and Functional Milestones in Total Knee Arthroplasty: Liposomal Bupivacaine versus Femoral Nerve Block

Clinical Orthopaedics and Related Research
Stephen W YuRichard Iorio

Abstract

Although pain management after total knee arthroplasty (TKA) affects rehabilitation, length of stay, and functional outcomes, pain management for patients undergoing TKA has yet to be standardized. Femoral nerve blocks (FNBs) are commonly used as an adjunct; however, these can result in transient quadriceps weakness and have been associated with in-hospital falls. Periarticular infiltration of liposomal bupivacaine has been recently introduced as a long-acting analgesic that can be administered without affecting motor function. (1) Does periarticular liposomal bupivacaine compared with FNB result in improved pain control as measured by pain scores and narcotic consumption? (2) How do liposomal bupivacaine and FNB compare in terms of gait and stairclimbing milestones and the proportion of patients who experienced a fall in the hospital? Between September 2013 and October 2014, a retrospective analysis was conducted involving 24 surgeons who performed a total of 1373 unilateral, primary TKAs. From September 2013 to April 2014, the routine approach to TKA pain management pathway consisted of preoperative administration of oral analgesics, intraoperative anesthesia (preferred spinal or general), an ultrasound-guided FNB, intraopera...Continue Reading

Associated Clinical Trials

References

Jul 14, 1998·Anesthesia and Analgesia·H W AllenB D Owens
May 6, 2003·The Journal of Arthroplasty·Chitranjan S RanawatAmor Mehta
Nov 19, 2003·The Journal of Pain : Official Journal of the American Pain Society·Michelle WheelerArthur G Lipman
Feb 14, 2009·Clinical Orthopaedics and Related Research·Aditya V MaheshwariChitranjan S Ranawat
Jun 26, 2009·The Journal of Arthroplasty·Robert J FeibelPaul E Beaulé
Aug 15, 2009·Clinical Orthopaedics and Related Research·Sanjeev SharmaWilliam L Healy
Sep 9, 2009·Journal of Pain and Symptom Management·Helena KnotkovaRussell K Portenoy
Jun 10, 2011·The Journal of Bone and Joint Surgery. American Volume·Javad ParviziKishor Gandhi
Oct 1, 2011·Clinical Orthopaedics and Related Research·Terence P MurphyKevin J Mulhall
May 6, 2014·The Journal of Arthroplasty·Deren T BagsbyR Michael Meneghini
Nov 9, 2014·The Bone & Joint Journal·M E BerendA V Lombardi

❮ Previous
Next ❯

Citations

Mar 16, 2017·The Journal of Arthroplasty·Kelvin Kim, Richard Iorio
May 26, 2017·Knee Surgery & Related Research·Sang Jun Song
Mar 13, 2018·Clinical Orthopaedics and Related Research·Stephen YuRichard Iorio
Oct 10, 2018·JBJS Reviews·James E FengRichard Iorio
Sep 27, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Joseph A BoscoRichard Iorio
Dec 19, 2018·JBJS Reviews·Andrew M PepperJonathan M Vigdorchik
Oct 10, 2019·The Journal of Bone and Joint Surgery. American Volume·Kyle John HancockMichael C Willey
Jul 23, 2016·Clinical Orthopaedics and Related Research·Philippe Richebé, Véronique Brulotte
Nov 1, 2017·The Journal of Bone and Joint Surgery. American Volume·Rachel B SeymourJoseph R Hsu
May 16, 2021·Archives of Orthopaedic and Trauma Surgery·David N KugelmanWilliam J Long

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.