| Objective:Comparative study on the effectiveness of modified and traditional "cocktail" injection methods in total knee arthroplasty.Methods:Seventy patients who underwent unilateral TKA for knee osteoarthritis in our department from January 2019 to March 2022 were retrospectively enrolled,and 35 patients who received the modified cocktail injection method were compared with 35 patients who received conventional injection method previously.In the modified cocktail injection group,all patients received only 20 ml "cocktail" injection of ropivacaine injection,ketorolac tritriol,epinephrine,and dextroxone in the posterior medial joint capsule of the knee for intraoperative analgesia prior to prosthesis installation.The remaining cocktail is injected into the quadriceps tendon,patellar ligament,and joint capsule after the prosthesis is installed.In the traditional cocktail injection group,all patients were injected with 20 ml cocktail in the anterolateral and anterolateral joint capsule and periosteum around femur and tibia before prosthesis installation,and the remaining cocktail was injected into quadriceps tendon,patellar ligament,and joint capsule after prosthesis installation.All patients received unified postoperative analgesia for 72 hours.We compared the resting VAS score and motor VAS score of patients at 6,12,24,48 and 72 hours postoperatively,as well as the maximum knee flexion at 24 and 48 hours postoperatively,straight leg elevation time and operation time of patients in the two groups.Results:Two groups of intra-articular injection "cocktail" analgesia method can obviously relieve pain after joint replacement level,whether it is a static dynamic VAS score,VAS score or,12,24,48,72 6 hours after surgery were significantly lower,improved injection group and the traditional injection group no significant statistical differences in the two groups in the straight leg-raising recovery ability,need time,When active knee flexion reached 90 degrees,there was no statistically significant difference in knee motion within 48 hours after operation,and the operation time of the modified injection group was shorter than that of the traditional injection group（P < 0.05）.Conclusion:There was no significant difference in postoperative analgesia effect between the two groups,but the operation time was significantly shortened.This study showed that the intra articular "cocktail" injection of analgesia provided good pain control,and the modified medial capsular injection group was more convenient and faster than the traditional injection group,saving surgical time,speeding up postoperative recovery,and reducing the risk of surgical adverse reactions. |
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