Functional Outcome of Femoral versus Obturator Nerve Block after Total Knee Arthroplasty

Patients undergoing total knee arthroplasty often experience substantial postoperative pain, which may delay functional recovery and hospital discharge. We recently reported the short-term analgesic efficacy of a single-injection femoral nerve block after spinal anesthesia in total knee arthroplasty...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2009-06, Vol.467 (6), p.1458-1462
Main Authors: Bergeron, Stephane G., Kardash, Kenneth J., Huk, Olga L., Zukor, David J., Antoniou, John
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
Arthroplasty, Replacement, Knee - methods
Arthroplasty, Replacement, Knee - rehabilitation
Conservative Orthopedics
Female
Femoral Nerve
Humans
Male
Medicine
Medicine & Public Health
Nerve Block - methods
Obturator Nerve
Orthopedics
Pain Measurement
Pain, Postoperative - prevention & control
Range of Motion, Articular
Recovery of Function
Sports Medicine
Surgery
Surgical Orthopedics
Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty
Treatment Outcome
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Summary:Patients undergoing total knee arthroplasty often experience substantial postoperative pain, which may delay functional recovery and hospital discharge. We recently reported the short-term analgesic efficacy of a single-injection femoral nerve block after spinal anesthesia in total knee arthroplasty. We have now followed 30 patients a minimum of 1 year to determine the functional outcome and pain relief after femoral and obturator nerve block after total knee arthroplasty. Patients undergoing primary unilateral total knee arthroplasty were randomized to one of three treatment groups: (1) femoral nerve block; (2) obturator nerve block; or (3) placebo (sham block). At 6 weeks and 1 year, all three groups had similar total Hospital for Special Surgery knee scores and similar subscores such as range of motion, daily function, and resting and dynamic pain. The data support the usefulness of a peripheral nerve blockade in the context of a multimodal analgesic regimen and a tailored rehabilitation program to individual patients and institutions. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-009-0732-y