Intraarticular Analgesia After Total Knee Arthroplasty, a Randomised Study

Study Overview
=================
Brief Summary
-----------------
The study aims to compare two different kinds of pain treatment after total knee replacement (operation with artificial knee joint): 1) a large local injection in and around the knee, supplemented with injection the day after, or 2) the department's conventional pain treatment consisting of continuous nerve block in the groin.

Detailed Description
-----------------
Postoperative pain after total knee arthroplasty is moderate to severe and can be difficult to treat. The current use of femoral nerve block by ropivacain pump for 48 hours provides considerable analgesia, but patients often experience slight motor block, inhibiting rehabilitation, and pain in the posterior part of the knee, innervated by the sciatic nerve. This study compares femoral nerve block to a new technique, where ropivacaine, ketorolac and adrenalin is used to infiltrate the tissue in and around the knee joint during surgery, and is injected by an intraarticular catheter at 10 pm on the day of surgery and again at 10 am the day after. Data of pain scores, analgesia consumption, adverse effects and mobilisation is collected for the first four postoperative days.

Official Title
-----------------
Postoperative Analgesia After Total Knee Arthroplasty. A Comparison of Continuous Femoral Block and Extensive Intraoperative Infiltration With Local Anesthetic Supplemented With Intraarticular Bolus the Following Day.

Conditions
-----------------
Arthroplasty, Replacement, Knee

Intervention / Treatment
-----------------
* Procedure: femoral nerve block
* Procedure: knee infiltration and injection via catheter


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patients planned for primary total knee arthroplasty due to primary arthrosis Exclusion Criteria: Patients unable to provide informed consent patients with contraindications for spinal anesthesia patients with known hypersensitivity towards the used drugs patients with severe chronic neurogenic pain or sensitivity disorders in the leg to be operated patients who have undergone major bone surgery in the knee to be operated

Ages Eligible for Study
-----------------
Minimum Age: 0 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: femoral nerve block|nan|
|Procedure: knee infiltration and injection via catheter|nan|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain, by numeric rating scale |  |  | 
| pain, by consumption of analgesics |  |  | 
| side effects |  |  | 
| return of function |  |  | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
postoperative pain, knee arthroplasty, analgesia, infiltration, femoral nerve block