A Comparison of the Efficacy and Complications Between Intraosseous and Periarticular Multimodal Analgesic Cocktail Injections After Primary Total Knee Arthroplasty: A Randomized Controlled Trial.
Warunyoo Suttikadsanee, Parn Pinsornsak, Piya Pinsornsak
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In 30 seconds
This prospective randomised controlled trial compared intraosseous (IO) with periarticular (PA) multimodal analgesic injections after primary total knee arthroplasty. Of 45 patients assigned to each group, 43 per group completed the study. IO injection was associated with significantly lower pain scores at rest and during movement at four, six and 12 hours, and at two weeks postoperatively. The IO group also had a faster Timed Up and Go test at 48 hours, but not at two weeks. Morphine use, other reported recovery measures and complications did not differ between groups through two weeks.
Key findings
- Pain scores at rest and during movement were significantly lower with IO injection at four, six and 12 hours and two weeks postoperatively.
- The Timed Up and Go test was faster with IO injection at 48 hours, but the difference was not present at two weeks.
- Morphine consumption, walking and discharge timing, postoperative range of motion, and complications showed no between-group differences through two weeks.
Why it matters
The trial suggests that the injection route may influence early pain control after total knee arthroplasty, while showing no detected difference in opioid consumption or complications. The short-term functional advantage was limited to the 48-hour assessment. These findings help characterise the potential benefits and observed outcomes of IO analgesia relative to standard PA injection.
What to keep in mind
The study included 43 completers per group, and reported outcomes only through two weeks, limiting assessment of longer-term effects.