Comparison of Early-Stage and Late-Stage Periarticular Injection for Pain Relief After Total Hip Arthroplasty: A Double-Blind Randomized Controlled Trial |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, Mito, Ibaraki, Japan;2. Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan;1. Department of Orthopaedic Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, People''s Republic of China;2. Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People''s Republic of China;3. Department of Orthopedics, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan, People''s Republic of China;4. Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People''s Republic of China;1. Duke University Medical Center, Department of Orthopaedic Surgery, Durham, NC;2. Section of Orthopaedic Surgery, University of Manitoba, Winnipeg, MB, Canada;3. Department of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada;4. Department of Orthopaedic Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada;1. Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY;2. Department of Medicine, Infectious Disease, Hospital for Special Surgery, New York, NY;1. Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX;2. Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT;3. American Association of Hip and Knee Surgeons, Rosemont, IL;4. Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA;1. Orthopedic Research Institute, Holy Cross Hospital, Ft. Lauderdale, FL;2. Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY;3. Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY;4. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH |
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| Abstract: | BackgroundNo randomized controlled trial has investigated a more optimal timing of periarticular injection for pain relief after total hip arthroplasty.MethodsThe study included 140 patients, and these patients were randomly allocated to the early-stage (periarticular injection was performed just before arthrotomy, and placebo was injected after implantation) or late-stage (placebo was injected just before arthrotomy, and periarticular injection was performed after implantation) injection groups. Other perioperative interventions were similar in all participants. The prespecified primary outcome was postoperative pain score at the recovery room.ResultsThe visual analog scale score at the recovery room of the early-stage injection group was significantly lower than that of the late-stage injection group (30 ± 28 vs 46 ± 30 mm; 95% CI, −25 to −5 mm; P = .0022), and this difference reaches a minimal clinically important difference level of 10 mm. No differences were observed with regard to complication rate.ConclusionEarly-stage periarticular injection during total hip arthroplasty provided better postoperative pain relief than late-stage periarticular injection without elevating complication rate.Level of EvidenceLevel I, randomized controlled trial. |
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| Keywords: | hip total hip arthroplasty pain management periarticular injection analgesia local infiltration analgesia |
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