In a prospective study, both intraarticular and periarticular injections exhibited similar analgesic effects in patients admitted for total knee arthroplasty (TKA). Researchers sought to compare the early clinical safety and effectiveness of intraarticular injection against periarticular analgesia in TKA. Overall, 100 patients scheduled to undergo TKA were incorporated and segregated into group A (n = 50) and group B (n = 50).

During surgery, patients in group A were given periarticular analgesia with 300 mg Ropivacaine and 5 mg Morphine (the medications were diluted with saline to 50 ml) in the subcutaneous tissues, extensor apparatus, posterior capsule, and periosteal borders. Tranexamic acid (TXA) 20 ml (2 g) was administered into the articular cavity following the stitching of the joint capsule. Following the stitching of the joint capsule, group B patients received intraarticular injections of the 70 mL mixture (2 g TXA, 5 mg Morphine, and 300 mg Ropivacaine).

The postoperative complications, pain, knee functional outcome, and length of stay (LOS) were explored. On postoperative days 1, 3, or 30, no clinically meaningful difference was there in visual analog scale (VAS) scores for knee pain between both groups. In Group A and B, the mean postoperative LOS is depicted in Table 1:

The mean swelling ratio did not significantly differ between groups at the 30-day follow-up, and neither did the range of motion (ROM) or Hospital for Special Surgery (HSS) knee score. The occurrence of complications, such as nausea and vomiting, deep vein thrombosis, and superficial wound infections did not statistically vary between Groups A and B.

The effectiveness of intraarticular injection and periarticular injection was found to be comparable in knee surgery. There is no discernible benefit in using periarticular injections over intraarticular injections. In the absence of a drainage tube, the authors suggested that intraarticular injection may be a superior approach to periarticular injection since it requires fewer surgical procedures and produces comparable postoperative results.