ArticlePain research & management2026
Old Versus New: A Historical Comparison of Anaesthesia Trends for Total Knee Arthroplasty and Patient Outcomes.
Article in Pain research & management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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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Who cites it
1 citing paper in PubMed.
- Old Versus New: A Historical Comparison of Anaesthesia Trends for Total Knee Arthroplasty and Patient Outcomes.Pain research & management · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
purposeTotal knee arthroplasty (TKA) is a widely performed procedure for end-stage knee osteoarthritis, with anaesthesia techniques evolving significantly in recent decades. This retrospective study examines trends in anaesthetic practice and postoperative outcomes at an Australian tertiary hospital network, using Acute Pain Service (APS) data from two distinct time periods (1999-2004 and 2018-2022).
methodsElective TKA patients enrolled in the acute pain service database from January 1999 to December 2004 (Cohort 1) and January 2018 to December 2022 (Cohort 2) were included. Baseline demographics and anaesthetic practices were compared descriptively. Postoperative outcomes were analysed using mixed-effects regression models adjusted for demographic and perioperative factors, with hospital included as a random effect. Outcomes included invasive pain management strategies, opioid consumption, pain scores, time to mobilisation, APS review duration and length of hospital stay.
resultsA total of 1273 patients were included (150 in Cohort 1 and 1123 in Cohort 2). Use of spinal anaesthesia increased significantly in Cohort 2 compared with Cohort 1 (96.4% versus 24.0%, p < 0.001), as did the adoption of regional anaesthesia techniques (74.3% versus 1.3%, p < 0.001). After adjustment, patients in Cohort 2 had significantly lower odds of requiring invasive pain management strategies (OR: 0.02 and 95% CI: 0.00-0.09; p < 0.001), mobilised earlier (β: -0.39 days, p = 0.009), required fewer days of APS review (β: -0.59 days, p < 0.001) and had shorter hospital stays (β: -2.44 days, p = 0.001). However, postoperative day one opioid consumption was higher in Cohort 2 (β: 55.19 mg oral morphine equivalents, p < 0.001), and movement-related pain scores were modestly increased (β: 1.00, p = 0.02). Resting pain scores and opioid-related side effects were comparable between cohorts.
conclusionsOver two decades, anaesthetic practice for TKA has shifted substantially toward neuraxial and motor-sparing regional techniques. These changes were independently associated with earlier mobilisation, reduced reliance on invasive pain strategies and shorter hospitalisation, despite higher early postoperative opioid use. The findings reflect evolving international practice patterns and highlight the importance of ongoing evaluation of perioperative care pathways.
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