Comparative Analgesic Effect After Total Knee Arthroplasty Between Intraosseous and Peri-articular Injection

Launched by THAMMASAT UNIVERSITY HOSPITAL · Jan 23, 2025

Keywords

ClinConnect Summary

This study compares two ways of giving pain relief during total knee replacement surgery. Researchers are testing whether injecting a multimodal pain mix into the center of the thigh bone (intraosseous) provides better pain control and less opioid use than injecting the same mix around the knee joint (peri-articular). The pain medicine includes a local anesthetic, adrenaline, morphine, and ketorolac, and pain will be measured with a 0–100 scale at multiple times for about two weeks after surgery, along with other recovery outcomes like nausea, knee movement, walking tests, and hospital stay.

Eligible participants are adults aged 50–80 undergoing a single knee replacement, with a fairly broad health range (ASA 1–3) and no major exclusions such as previous knee surgery, kidney or liver problems, BMI over 35, certain heart conditions, or allergies to study drugs. About 90 people will be enrolled at Thammasat University Hospital in Thailand. If you take part, you’ll be randomly assigned to one of the two injection methods during surgery and neither you nor the outcome assessors will know which method you received. You’ll also receive standard pain medications. The trial is currently enrolling, and results are not yet available; it aims to finish around mid-2025.

Gender

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Eligibility criteria

• Inclusion Criteria:
• • 50 - 80 yrs of age ASA classification: 1-3 Unilateral TKA
• Exclusion Criteria:
• • Secondary OA knee Previous knee surgery Can't undertaken spinal block and adductor canal block Renal insuf. (Crcl \< 30 ml/min) History of convulsive disorder Abnormal liver function BMI \> 35 Kg/M2 Allergy to study drugs History of coronary disease Hb \< 10 (g/dl) Can't understand 100mm-VAS assessment Refuse to recruit in the study, or refuse follow up Using opioid in 5 days before surgery Unstable vital sign History current VTE Using anti-platelet or anti-coagulation medicine Severe deformity