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Randomized Controlled Trial
. 2009 Jun;467(6):1458-62.
doi: 10.1007/s11999-009-0732-y. Epub 2009 Feb 18.

Functional outcome of femoral versus obturator nerve block after total knee arthroplasty

Stephane G Bergeron  1 , Kenneth J Kardash, Olga L Huk, David J Zukor, John Antoniou
Affiliations
Randomized Controlled Trial

Functional outcome of femoral versus obturator nerve block after total knee arthroplasty

Stephane G Bergeron et al. Clin Orthop Relat Res. 2009 Jun.

Abstract

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.

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Figures

Fig. 1
Fig. 1
Total Hospital for Special Surgery (HSS) knee scores are shown. Patients were evaluated preoperatively and at 6 weeks and 1 year postoperatively. The data demonstrate no difference in HSS scores at 6 weeks and 1 year among the three study groups.
Fig. 2
Fig. 2
Hospital for Special Surgery (HSS) knee subscores are shown. Patients were evaluated preoperatively and at 6 weeks and 1 year postoperatively. The data demonstrate no difference in HSS subscores at 6 weeks and 1 year among the three study groups. ROM = range of motion.
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