Shuji Nakagawa" /> " /> " /> " /> " /> " /> " /> " /> " /> " /> " /> Shuji Nakagawa, MD, Yuji Arai, MD, Hiroaki Inoue, MD, Hiroyuki Kan, MD, Manabu Hino, MD, Shohei Ichimaru, MD, Kazuya Ikoma, MD, Hiroyoshi Fujiwara, MD, Fumimasa Amaya, MD, Teiji Sawa, MD, and Toshikazu Kubo, MD" /> Shuji Nakagawa, MD, Yuji Arai, MD, Hiroaki Inoue, MD, Hiroyuki Kan, MD, Manabu Hino, MD, Shohei Ichimaru, MD, Kazuya Ikoma, MD, Hiroyoshi Fujiwara, MD, Fumimasa Amaya, MD, Teiji Sawa, MD, and Toshikazu Kubo, MD. Knee Surg Relat Res 2016;28:233-8. https://doi.org/10.5792/ksrr.2016.28.3.233">
Knee Surg Relat Res 2016 Sep; 28(3): 233-238  https://doi.org/10.5792/ksrr.2016.28.3.233
Comparative Effects of Periarticular Multimodal Drug Injection and Single-Shot Femoral Nerve Block on Pain Following Total Knee Arthroplasty and Factors Influencing Their Effectiveness
Shuji Nakagawa, MD1, Yuji Arai, MD1, Hiroaki Inoue, MD1, Hiroyuki Kan, MD1, Manabu Hino, MD1, Shohei Ichimaru, MD1, Kazuya Ikoma, MD1, Hiroyoshi Fujiwara, MD1, Fumimasa Amaya, MD2, Teiji Sawa, MD2, and Toshikazu Kubo, MD1
Departments of 1Orthopaedics and 2Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Correspondence to: Yuji Arai, MD 
Department of Orthopaedics, Graduate School of Medical Science,
Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-
Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan 
Tel: +81-75-251-5549, Fax: +81-75-251-5841 
Received: February 8, 2016; Revised: March 27, 2016; Published online: September 1, 2016.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods. 
Materials and Methods: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90o of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated. 
Results: The VAS scores did not differ significantly between two groups, whereas the amount of analgesics used was significantly lower in the LIA group. Preoperative flexion contracture was significantly more severe in the LIA group with high VAS compared with low VAS. No serious adverse event occurred in the LIA or FNB group. 
Conclusions: The lower analgesic usage in the LIA group than the FNB group indicates that the analgesic effect of LIA was greater than that of singleshot FNB after TKA. There were no serious complications in either group. The postoperative analgesic effect of LIA was smaller in patients with severe than less severe preoperative flexion contracture.
Keywords: Knee, Arthroplasty, Femoral nerve block, Local infiltration analgesia, Flexion contracture
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