Introduction: Early recovery after TKR is currently one of the main challenges faced by orthopedic surgeons. The decrease in pain during the postoperative period improves functional outcome, shortens hospital stay and brings down the complications rate. We compared 3 methods of analgesia for post TKR surgery.

Materials and methods: We carried out a prospective randomized study using three types of postoperative analgesia: group 1: epidural catheter, group 2: intradural analgesia plus femoral block and group 3: periarticular infiltration with an analgesic cocktail before incision closure. We included 90 consecutive TKRs performed between May and December 2006, which were randomized into one of the 3 groups. The following variables were measured at 6, 24, 48, 72 hours and on discharge: VAS (visual analgesic scale), blood pressure, heart rate, need for rescue analgesia, functional recovery of the patient, hospital stay and rate of complications.

Results: Patients in group 1 had higher VAS values and a greater need of rescue analgesia. The best results were seen in group 3 (local infiltration) followed by group 2. The differences as regards locomotion and mean hospital stay were correlated with VAS values but were not statistically significant.

Conclusions: We believe that periarticular infiltration with an analgesic cocktail before incision closure is a good treatment option for postoperative pain in TKR.