Comparative Effects of Two Periarticular Analgesic Cocktails on Pain Reduction and Inflammatory Response After Unicompartmental Knee Arthroplasty
J Vis Exp. 2026 Jun 12;(232). doi: 10.3791/70959.
ABSTRACT
Unicompartmental knee arthroplasty (UKA) serves as the primary surgical treatment for isolated unicompartmental knee osteoarthritis. Clinical data of 108 patients who underwent UKA at Yueyang People's Hospital from January 2020 to December 2024 were retrospectively screened. After strict case exclusion, 102 patients were categorized into Group A (ropivacaine combined with morphine and compound betamethasone, n = 52) and Group B (ropivacaine combined with ketorolac tromethamine and epinephrine, n = 50). Propensity score matching (PSM) was subsequently performed to balance baseline characteristics, resulting in 46 patients per group after matching. Primary outcomes consisted of resting and active visual analog scale (VAS) scores, 48 h postoperative opioid consumption, and inflammatory biomarkers, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), and neutrophil (NEUT) levels. Secondary outcomes covered knee range of motion (ROM), time to initial postoperative ambulation, Knee Injury and Osteoarthritis Outcome Score (KOOS), Barthel Index (BI), and postoperative adverse events. Baseline parameters were well balanced between the two groups following PSM (all P > 0.05). At 48 h postoperatively, Group B presented significantly decreased resting and active VAS scores, as well as lower 48 h opioid consumption (all P < 0.001). Milder elevations of CRP, ESR, WBC, and NEUT were observed in Group B (all P < 0.001). Additionally, Group B demonstrated superior knee functional recovery reflected by better ROM, higher KOOS and BI scores, and shorter time to first ambulation (all P < 0.001). No significant intergroup difference was detected in the incidence of adverse events (P = 0.503). In this single-center retrospective cohort, the ropivacaine-ketorolac-epinephrine cocktail demonstrates superior analgesic and anti-inflammatory properties with a noninferior safety profile. Limited by the single-center, retrospective design, this regimen is preliminarily considered a promising analgesic alternative for UKA patients, and further large-sample, multicenter, prospective studies are required for validation.
PMID:42371821 | DOI:10.3791/70959