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

  • Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

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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Acknowledgments

We thank Alain Petit for help in the preparation of the manuscript and Maricar Alminia and Laura Des Rosiers for administration of the questionnaires and recording the clinical data.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Canada

    Stephane G. Bergeron MD

  2. Department of Anesthesia, SMBD-Jewish General Hospital, Montreal, Canada

    Kenneth J. Kardash MD

  3. Department of Orthopaedics, SMBD-Jewish General Hospital, Room E-003, 3755, Chemin de la Côte Ste-Catherine, Montreal, QC, H3T 1E2, Canada

    Olga L. Huk MD, MSc, David J. Zukor MD & John Antoniou MD, PhD

Authors
  1. Stephane G. Bergeron MD
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  2. Kenneth J. Kardash MD
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  3. Olga L. Huk MD, MSc
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  4. David J. Zukor MD
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  5. John Antoniou MD, PhD
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Corresponding author

Correspondence to John Antoniou MD, PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Bergeron, S.G., Kardash, K.J., Huk, O.L. et al. Functional Outcome of Femoral versus Obturator Nerve Block after Total Knee Arthroplasty. Clin Orthop Relat Res 467, 1458–1462 (2009). https://doi.org/10.1007/s11999-009-0732-y

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  • DOI: https://doi.org/10.1007/s11999-009-0732-y

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