Assistant Professor, SRM Medical College Hospital and Research Centre, Chennai, Tamilnadu, India
Total knee replacement ,TKA ,Periarticular ,Cocktail injection ,Knee flexion ,Visual analog scale ,

Pain after total knee arthroplasty (TKA) is unsolved clinical problems. Some studies reported that periarticular cocktail injection can effectively reduce pain. However, there was no gold standard about the cocktail ingredient and injection location. More osteotomy and less soft tissue release in TKA with mild deformity; besides, plenty of nerves and blood vessels are contained in the periosteums and bone marrow. In this study, we aimed to detect the clinical results of subperiosteal cocktail application in TKA.Two groups were included according to the different injection location in our study. In group 1, cocktails were injected into the muscles, tendons, suprapatellar bursa, and subpatellar bursa surrounding knee joint. In group 2, cocktail injection was performed under the periosteum of the distal femur and proximal tibia. Our primary outcomes were visual analogue scale (VAS) ,operation time, and hospitalization.At the first operative day, the mean with standard deviation VAS score in a state of static was lower in group 2 compared with group 1 (0.97 ± 0.25 in group 1 and 0.81 ± 0.54 in group 2, p < 0.05). In the state of flexion and extension, the mean with SD VAS was 1.62 ± 0.65 in group 1 and 1.15 ± 0.46 in group 2 (p < 0.05). We concluded that subperiosteal cocktail injection can significantly reduce pain compared with periarticular cocktail injection after TKA.

1 , 1 , 2011