ArticleJB & JS open access
Comparison of the Effect of Intra-Articular, Periarticular, and Combined Injection of Analgesic on Pain Following Total Knee Arthroplasty: A Double-Blinded Randomized Clinical Trial.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 5 citations in OpenAlex.
- A new approach in the treatment of ultrasound-guided synovial hypertrophy.Turkish journal of medical sciences · 2025Article
- The Role of Periarticular Injections for Postoperative Pain after Total Knee Arthroplasty.The archives of bone and joint surgery · 2025Article
- Comparison of analgesic effects between betamethasone and dexamethasone in total knee arthroplasty: a prospective randomized controlled trial.Frontiers in medicine · 2025Article
- Is periarticular injection superior to intraarticular injection to reduce postoperative pain following total knee arthroplasty?Joint diseases and related surgery · 2023Article
- Effect of 1-Month Oral Oxycodone on Postoperative Pain Following Total Knee Arthroplasty.JB & JS open accessArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this study was to compare the efficacy of 3 methods of intraoperative analgesic cocktail injection during total knee arthroplasty (TKA)-intra-articular (IA), periarticular (PA), and combined intra-articular and periarticular (IA+PA)-on controlling early postoperative pain. Methods: This was a prospective double-blinded parallel randomized clinical trial. A total of 153 patients scheduled for TKA were allocated to IA, PA, or IA+PA (51 patients each) by block randomization. The primary outcome was morphine consumption. Secondary outcomes were visual analogue scale (VAS) pain, knee flexion, straight leg raising, Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The morphine consumption was lowest in the PA group (median = 0, interquartile range [IQR] = 5) and highest in the IA group (median = 10, IQR = 5). The PA group had significantly lower VAS pain at rest than either IA (mean difference = -0.70; 95% confidence interval [CI] = -0.93 to -0.46; p < 0.001) or PA+IA (mean difference = -0.41; 95% CI = -0.65 to -0.18; p < 0.001). The PA group had also lower VAS pain during activity compared with IA (mean difference = -0.63; 95% CI = -0.85 to -0.40; p < 0.001) and IA+PA (mean difference = -0.38; 95% CI = -0.61 to -0.16; p < 0.001). The PA group had significantly greater active knee flexion compared with IA (mean difference = 9.68°; 95% CI = 5.50° to 13.86°; p < 0.001) and IA+PA (mean difference = 5.13°; 95% CI = 0.95° to 9.31°; p = 0.010). Passive knee flexion was greater for PA than IA (mean difference = 7.85°; 95% CI = 4.25° to 11.44°; p < 0.001). Other outcome variables were not significantly different among the 3 groups. The only complications were wound drainage (1 each in the IA and IA+PA groups) and deep venous thrombosis (1 in the IA group). Conclusions: PA was associated with less early postoperative pain and greater active knee flexion compared with the other 2 analgesic methods. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.