- A randomized controlled trial finds that early is no better than late periarticular multimodal drug injection (PMDI) for pain and functional recovery after bilateral total knee arthroplasty (TKA).
Why this matters
- Findings do not justify change in standard practice of late timing of PMDI administration.
- Randomized, double-blinded, controlled trial (n=48) of early PMDI (immediately after knee arthrotomy) vs late PMDI (before prosthetic implantation).
- PMDI consists of bupivacaine (100 mg), Ketorolac (30 mg), morphine sulfate (5 mg), and adrenaline (300 μg).
- Pain at rest (by visual analog scale [VAS]) and most functional recovery measures were assessed at various points up to 6 weeks postoperatively.
- Funding: None.
- No differences between groups in the following:
- operative duration,
- drain output (24-48 hours),
- VAS at rest (6 hours-6 weeks),
- degrees of knee flexion using continuous passive motion (24-96 hours),
- degrees of active knee flexion (2-6 weeks),
- degrees of straight leg raising (48 hours-6 weeks), and
- degrees of extension (48 hours-6 weeks).
- Small sample sizes.