Study Summary

Seventy-eight patients with advanced knee osteoarthritis (KOA) undergoing unilateral total knee arthroplasty (TKA) were randomized to receive no injection, traditional periarticular injection (PAI), or periarticular injection with genicular nerve infiltration (GNI) targeting the superomedial, superolateral, and inferomedial genicular nerves. The primary outcome of interest was postoperative visual analog scale (VAS) pain scores at rest and during motion. Secondary outcomes included opioid consumption, time to first opioid request, knee range of motion (ROM), modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and hospital length of stay. Outcomes were assessed at 4, 24, and 48 hours and at 2 and 6 weeks postoperatively. Overall, the results of the study revealed that both the PAI and GNI groups achieved significantly better postoperative pain control, lower opioid use, and improved early knee extension compared with the control group, while outcomes between the PAI and GNI groups were similar. The findings suggest that intraoperative GNI is an effective alternative to conventional PAI for postoperative pain management after TKA.