Assessing Functional Outcomes and Pain Intensity Variations After Total Knee Arthroplasty: A Comparative Analysis of Pain Block Techniques.

Abstract

This study aimed to compare post-total knee arthroplasty (TKA) outcomes (function, pain, and quadriceps strength) between femoral nerve block (FNB), intra-articular block, and a control group. In addition, it sought to identify predictors of postoperative functional capacity. Fifty-four TKA patients were evaluated. Preoperative assessments included quadriceps strength and the Oxford knee score. Postoperative assessments on days 1 and 3/4 included the timed up and go (TUG), Elderly Mobility Scale, and Five Times Sit-to-Stand tests. Pain levels, hospitalization duration, surgical time, complications, and falls were also recorded. No significant differences in functional outcomes, pain levels, or quadriceps strength were found between the FNB, intra-articular block, and control groups, except for the TUG test on day 3/4, which favored FNB (P < 0.01). Preoperative quadriceps strength was a valuable predictor of early functional outcomes, with FNB improving TUG scores on day 3/4. The choice of pain block technique had limited effect on short-term functional outcomes post-TKA, except for early mobility as measured by the TUG test on day 3/4. Preoperative quadriceps strength markedly predicted initial functional performance. Additional research is needed to enhance postoperative pain management and early rehabilitation strategies. NCT05478005.