Function and Pain Following Knee Replacement

University of Haifa

Status: Completed

Conditions: Pain, Postoperative; Post Operative Pain; Knee Arthropathy

Treatments: Procedure: Intra-articular block; Procedure: Femoral nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT05478005

UHaifa-MEGK

Details and patient eligibility

About

The goal of this interventional study is to compare pain management techniques (femoral nerve block, intra-articular block, none) in TKA patients. The main questions it aims to answer are:

• Are there differences in postoperative outcomes?
• Does preoperative quadriceps muscle strength predict early functional ability? Participants underwent TKA and assessments. Researchers compared pain management techniques to assess effects on postoperative outcomes and identified the importance of preoperative quadriceps muscle strength as a predictor of early functional ability. Further research is required to refine postoperative pain management strategies.

Full description

Total knee arthroplasty (TKA) is a frequently undertaken elective orthopedic intervention for severe knee osteoarthritis, frequently yielding postoperative discomfort and complications. Peripheral nerve blocks, notably femoral nerve blocks, are commonly utilized for analgesia but may transiently impede motor nerve function, weakening the quadriceps muscle. Intra-articular blocks offer a potential alternative to mitigate motor impairment. However, there exists a dearth of information regarding the comparative effectiveness of these methods with respect to short-term functional outcomes in the immediate postoperative phase following TKA.

Objectives: This study assesses functional outcomes, pain, quadriceps strength after TKA with femoral nerve block, intra-articular block, and a control group. It identifies predictors of postoperative functional ability.

Methods: 54 patients undergoing TKA were evaluated, measuring pre-op quadriceps strength, and utilizing the Oxford Knee Score for functionality. Post-op, we evaluated mobility using the Timed Up & Go, Elderly Mobility Scale, and Five Times Sit-to-Stand tests on POD 1 & 3/4. Pain levels, hospitalization, surgical duration, complications, and falls were also recorded.

Enrollment: 54 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Men and women, over the age of 18, electively assigned for primary knee replacement surgery.
• ASA score 1-3

Exclusion criteria

• Revision surgery
• Patients suffering from chronic pain syndrome or chronic opioid use.
• Patients with previous neurological deficits in the lower extremities.
• A cognitive state that does not allow signing of consent or understanding simple instructions.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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54 participants in 3 patient groups

Femoral nerve block

Experimental group

Description:

Patients undergoing total knee arthroplasty received a single-shot femoral nerve block during the surgical procedure.

Treatment:

Procedure: Femoral nerve block

Intra-articular block

Experimental group

Description:

Patients undergoing total knee arthroplasty received a intra-articular block during the surgical procedure.

Treatment:

Procedure: Intra-articular block

Control group

No Intervention group

Description:

Patients undergoing total knee arthroplasty and didn't receive pain block.