Abstract
Introduction and Aims: To perform a pilot study to compare regional infiltration with standard (patient cotrolled or epidural) analgesia following total knee arthroplasty.
Method: Visual Analogue (VAS) scale assessment of peri-operative pain and nausea, analgesic consumption, time to mobilise from bed and range of motion at four days post-operation were compared between the two groups. Complications were documented. All operations were performed by the same surgeon (RB) and the first 79 cases were compared with an historical control group comprising the 73 cases immediately preceeding the study group. There were no exclusions from either group.
Results: The mean visual analogue score (VAS) for pain in the peri-operative period was of 3.19/10 (vs. 4.1 in controls) (p=0.02). Only four RAMP patients (5.1%) required any post-operative parenteral opiate analgesia (vs. 93.2% of controls) (p=< 0.0001). Early rehabilitation was more rapid in the RAMP patients; the mean time from return to the ward to walking was five hours 25 minutes compared to 63 hours 58 minutes in the controls (p=< 0.0001). The mean inpatient stay for RAMP patients was 6.5 days and 9.6 in controls (p=0.01). No RAMP patient required urinary catheterisation which was necessary in 42 (57%) of control patients.
Conclusion: Despite a lower incidence of patella resurfacing in the study group and a significant difference in implants, (study group mostly ‘Profix’ and controls mostly ‘Natural Knees’, regional infiltration appears to be safe and to confer substantial benefit in reducing acute morbidity.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
