{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:19:54Z","timestamp":1790083194584,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Although the analgesic effect of periarticular injection after total knee arthroplasty (TKA) has been well documented, the gold standard for drug combination has not yet been established. In this study, the analgesic effects of six different drug combinations were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 256 patients undergoing TKA for primary osteoarthritis were randomized into one of six groups: a control group (saline solution, epinephrine, and cefazolin, <jats:italic>n<\/jats:italic> = 42), Group 1 (ropivacaine, <jats:italic>n<\/jats:italic> = 43), Group 2 (ropivacaine + morphine, <jats:italic>n<\/jats:italic> = 43), Group 3 (ropivacaine + ketorolac, <jats:italic>n<\/jats:italic> = 42), Group 4 (ropivacaine + morphine + ketorolac, <jats:italic>n<\/jats:italic> = 43), and Group 5 (ropivacaine + morphine + ketorolac + methylprednisolone, <jats:italic>n<\/jats:italic> = 43). Pain level assessed by visual analogue scale (VAS) and opioid consumption were primary outcomes. The incidence of complications, range of motion (ROM), C\u2010reactive protein (CRP) value, and the amount of post\u2010operative blood drainage were also compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in Groups 4 and 5 complained less pain than the control group for the first 12 h after surgery, and the patients in the other groups showed less pain only during the initial 6 h after surgery. Groups 4 and 5 also showed less opioid consumption than the control group during the 24 h period after surgery. Patients in Group 5 showed no significant difference in VAS score and opioid consumption compared with Group 4, but they had lower CRP value and greater ROM than any other groups at post\u2010operative day 2 and day 4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of ropivacaine, morphine, and ketorolac showed a significantly stronger and sufficiently synergistic analgesic effect without adding methylprednisolone in periarticular injection after TKA. The clinical relevance of the study is that the combination of ropivacaine, morphine, and ketorolac can be a good option for periarticular injection following TKA in terms of synergistic analgesic effect and efficiency of drug combination.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3366-x","type":"journal-article","created":{"date-parts":[[2014,10,6]],"date-time":"2014-10-06T03:33:30Z","timestamp":1412566410000},"page":"838-845","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Which analgesic mixture is appropriate for periarticular injection after total knee arthroplasty? Prospective, randomized, double\u2010blind study"],"prefix":"10.1002","volume":"23","author":[{"given":"Tae Woo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Hallym University Hospital 77, Sakju\u2010ro 200\u2010704 Chuncheon\u2010si Gangwon\u2010do Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Jae","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University Hospital 101 Daehang\u2010ro, Jongno\u2010gu 110\u2010744 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Hyeok","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University Hospital 101 Daehang\u2010ro, Jongno\u2010gu 110\u2010744 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Cheol","family":"Seong","sequence":"additional","affiliation":[{"name":"Department of 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