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Abstract
Background and Aims Primary outcome was to assess if femoral nerve block (FNB) could affect long-term pain and function after total knee arthroplasty (TKA) (1).
Methods Ethics Committee approved this retrospective study, patients (age 18–90 years) operated from unilateral TKA one year before were included and divided in 2 groups: patients receiving spinal anesthesia (hyperbaric bupivacaine±sufentanil) or spinal anesthesia with FNB (50–100 mg levobupivacaine). Impact of age, gender, BMI, height, durations of surgery and tourniquet over the pain and disability were also evaluated. Patients were asked to evaluate pain before (NRS) and after TKA with the Numeric Rating Scale (NRS1) and functional disability with the Oxford Knee Score one year after surgery (OKS1).
Results Continous variables were compared between groups with Wilcoxon test, discrete variables with Chi² Pearson test; p<0.05 significant. 111 patients were included (24 with FNB) There is no difference in term of OKS1 (42 [39 – 46] vs 43.5 [38.75 – 46]; p=0.87) when FNB is added to spinal anesthesia. Median OKS1 is superior for men compared to women (41 [37.75 – 44.25] vs 45 [40 – 46]; p= 0.01). When comparing OKS1>40 with OKS1<40, in group OKS1>40: Median Height and delta (NRS1-NRS) are superior (height: 1.65 [1.56 – 1.71] vs 1.68 [1.63 – 1.76]; p= 0.02. Delta NRS: -4 [-6 – -2] vs -6 [-8 – -4] p<0.01); NRS1 is inferior (4 [2 – 5] vs 1 [0 – 2]; p<0.001).
Conclusions FNB does not improve long-term pain and knee function. Knee function seems to be improved by the decrease of pain, the gender and the height.
