Study protocol for comparison of post-operative pain between intraosseous multimodal injection and periarticular multimodal injection in Simultaneous Bilateral Total Knee Arthroplasty – A Randomized Controlled Trial

Abstraction Background: Total knee arthroplasty (TKA) was the procedure which is preform by orthopedic surgeons in end stage osteoarthritis knee patients who fail conservative treatment. Periarticular analgesia is one of the effective and safe technique used to reduce pain after surgery. However, the location and formula of the mixture have not yet been controversy. Recently, a study compared intraosseous analgesic injection, which provided significant postoperative pain relief compared to the control group. The authors conducted this study to compare periarticular and intraosseous analgesic injection in patients undergoing simultaneous bilateral total knee arthroplasty. Method: The study is a two-arm, double-blinded, randomized controlled trial with 26 patients (52 knees) who underwent simultaneous bilateral total knee arthroplasty. The primary outcome is postoperative pain at 12, 24, and 48 hours using the Visual Analog Scale for assessment. The secondary outcomes include postoperative range of motion at 24 and 48 hours, postoperative blood loss, and postoperative complications. Discussion: While periarticular analgesic is the standard practice, intraosseous analgesic injection is a potential route for controlling postoperative pain after total knee arthroplasty surgery. This study offers a better alternative route for analgesic injection.