Total knee replacement is associated with severe post-operative pain. The purpose of this study is to compare two methods of treatment for pain control following Total Knee Replacement with an accelerated physical therapy protocol to aid the achievement of rehab milestones.
A total of 106 patients undergoing total knee arthroplasty will be randomized into two groups: one to receive only Periarticular injections and the other periarticular injections AND adductor canal block. Patients will be asked their numeric pain scores before surgery as baseline and at 24 and 48 hours post-operation. Patients also will be asked questions from painOUT questionnaire at 24 and 48 hours. Time to reach discharge criteria based on physical therapy assessments will also be measured.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
111
Hospital for Special Surgery
New York, New York, United States
Time to Meet Physical Therapy Discharge Criteria
Time to reach physical therapy (PT) goals
Time frame: First 3 days post-operatively
Numerical Rating Scale (NRS) Pain Scores With Ambulation Postoperative Day 1
Patient reported pain scores on postoperative day 1 from 0-10. 0 being no pain, 10 being the worst pain imaginable.
Time frame: 24 hours after operating room discharge
NRS Pain Score With Movement POD2
NRS pain with movement as reported by the patient. Rated from 0-10. 0 being no pain, 10 being the worst pain imaginable.
Time frame: 48 hours after surgery
Opioid Consumption Postoperative Day (POD) 1
Opioid consumption for patients from 0-24 hours postoperative, measured in mg OME (oral morphine equivalents)
Time frame: 0-24 hours postoperatively
Opioid Consumption POD2
Opioid consumption over hours 24-48 postoperatively. Measured in mg OME (oral morphine equivalents). Higher equates to more opioids consumed.
Time frame: 24-48 hours postoperative
Hospital Length of Stay
Measured in minutes.
Time frame: Average of 3 days
Patient Outcome Questionnaire (painOUT) Least Pain for 0-24 Hours Postoperatively
Measures: least pain in the last 24 hours. Scores are measured from 0-10. 0 being no pain to 10 being the worst pain imaginable.
Time frame: Participants will be followed for the duration of 2 days post operatively in the hospital
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Patient Outcome Questionnaire (painOUT) Least Pain for 24-48 Hours Postoperatively
Least pain experienced from 24-48 hours postoperative on a scale from 0-10. 0 being no pain at all to 10 being the worst pain imaginable
Time frame: 24-48 hours postoperative
Patient Outcome Questionnaire (painOUT) Most Pain for 0-24 Hours Postoperatively
Painout most pain experienced 0-24 hours postoperatively, measured from 0-10. 0 being no pain to 10 being the worst pain imaginable
Time frame: 0-24 hours postoperatively
Patient Outcome Questionnaire (painOUT) Most Pain for 24-48 Hours Postoperatively
Painout most pain experienced 24-48 hours postoperatively measured on a scale from 0-10. Higher scores indicate higher pain levels.
Time frame: 24-48 hours postoperative
Knee Society Score (KSS) at 6 Weeks Postoperatively
KSS (Knee Society Score) score measured at 6 weeks postoperatively. The scale is from 0-100. Scores below 60 indicate poor function, 60-69 indicate fair, 70-79 indicate good, and 80-100 indicate excellent functional scores. KSS measures knee pain, flexion contracture,extension lag, alignment, stability, and total range of flexion and generates an associated score correlating to knee function. Higher is better. There is no sub score - only the cumulative Knee Society Score.
Time frame: Post operatively at approximately 6 weeks after surgery