To compare the effects of intra-articular cocktail injection and periarticular injection on pain and knee movement after total knee arthroplasty (TKA).

From April 2019 to January 2020 in Xiangya Hospital, Central South University, the patients who needed unilateral TKA due to osteoarthritis were evaluated as study cohort. Inclusion criteria: patients undergoing unilateral TKA for the first time; no abnormality was found in preoperative platelet, coagulation function and venous ultrasound of both lower limbs; good compliance. Exclusion criteria: patients with neuropathic pain and sensory disorders; stop taking anticoagulant or aspirin for less than one week; definite allergy or contraindication to triamcinolone, ropivacaine or tranexamic acid; severe hepatic and renal insufficiency; high risk of thrombosis; bilateral TKA was performed during hospitalization. Ninety patients were enrolled and divided into the intra-articular group (n=47) and the peri-articular group (n=43). During the operation, cocktail injections were given into the articular cavity in the intra-articular group and around the joints in the peri-articular group. The general information of the patients was recorded; the degree of pain was evaluated by visual analogue scale (VAS) of pain and the recovery of motor function was evaluated by joint range of motion (ROM), the time of active straight leg raising (SLR) and the time of 90° knee flexion. The results were analyzed by independent sample t test, repeated measures anova and chi-square test.

There was no statistically significant difference in rest VAS(F=0.120, P>0.05) and activity VAS(F=0.321, P>0.05) between the two groups before and after operation, and there was no statistically significant difference in ROM(F=0.688, P>0.05) between the two groups before operation and after operation. There was no statistically significant difference between postoperative SLR(t=0.755, P>0.05) and postoperative 90° knee flexion time(t=-1.234, P>0.05) in both groups.

There is no statistically significant difference in early postoperative analgesia and motor rehabilitation outcomes between the cocktail of intra-articular injection and peri-articular injection after total knee arthroplasty within two weeks.