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The Bone & Joint Journal
Vol. 98-B, Issue 9 | Pages 1189 - 1196
1 Sep 2016
The technique of delivery of peri-operative analgesia does not affect the rehabilitation or outcomes following total knee arthroplasty
McDonald DA Deakin AH Ellis BM Robb Y Howe TE Kinninmonth AWG Scott NB
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Aims

This non-blinded randomised controlled trial compared the effect of patient-controlled epidural analgesia (PCEA) versus local infiltration analgesia (LIA) within an established enhanced recovery programme on the attainment of discharge criteria and recovery one year after total knee arthroplasty (TKA). The hypothesis was that LIA would increase the proportion of patients discharged from rehabilitation by the fourth post-operative day but would not affect outcomes at one year.

Patients and Methods

A total of 242 patients were randomised; 20 were excluded due to failure of spinal anaesthesia leaving 109 patients in the PCEA group and 113 in the LIA group. Patients were reviewed at six weeks and one year post-operatively.

Bone & Joint Research
Vol. 3, Issue 6 | Pages 212 - 216
1 Jun 2014
The role of retraction in direct nerve injury in total hip replacement
McConaghie FA Payne AP Kinninmonth AWG
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Objectives

Acetabular retractors have been implicated in damage to the femoral and obturator nerves during total hip replacement. The aim of this study was to determine the anatomical relationship between retractor placement and these nerves.

Methods

A posterior approach to the hip was carried out in six fresh cadaveric half pelves. Large Hohmann acetabular retractors were placed anteriorly, over the acetabular lip, and inferiorly, and their relationship to the femoral and obturator nerves was examined.