Novel strategies to improve early outcomes following total knee arthroplasty: a case control study of intra articular injection versus femoral nerve block

The incidence of total joint arthroplasty is rapidly increasing. As costs are rising as well, orthopaedic surgeons are now being called on to demonstrate the value of our procedures. We recently evaluated a new technique of local injection in total knee arthroplasty (TKA) as a potential means to improve quality and decrease costs. A case-control study was performed. One hundred patients were prospectively studied receiving a novel local injection using liposomal bupivicaine in TKA. These were compared to a historical cohort of 100 patients receiving a femoral nerve catheter. We found that patients receiving liposomal bupivicaine had improved pain scores, shorter lengths of stay, slightly less opioid intake, and large decreases in costs. Local injection in TKA with liposomal bupivicaine appears to be a useful tool in adding value to patient care. This technique was shown to improve patient outcomes while simultaneously decreasing costs.