{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:54:57Z","timestamp":1763463297335,"version":"3.45.0"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Objective: The aim of this study was to compare the efficacy of combined periarticular and incisional injections versus periarticular injection alone of bupivacaine in reducing post-operative pain after total knee arthroplasty (TKA).\n\nMethods: In this prospective, randomized, double-blind comparative study, 90 patients with primary osteoarthritis who underwent TKA were enrolled. The patients were then randomly divided into 3 groups (30 in each): group 1, without injection; group 2, with periarticular injection of 20 mL 0.5% bupivacaine hydrogen chloride (HCl) (100 mg) after implantation; and group 3, periarticular injection of 20 mL 0.5% bupivacaine HCl (100 mg) after implantation and incisional injection of 10 mL 0.5% bupivacaine HCl (50 mg) before wound closure. Post-operative pain levels were measured using a 100-mm visual analogue scale (VAS) (0 mm: no pain and 100 mm: worst pain) at 30 min and 1, 2, 4, and 6 h, post-operatively.\n\nResults: The mean VAS score in group 3 (the combined group-periarticular and incisional injections) within the first 4 h was lower than that in group 1 and group 2 (p&lt;0.001). The mean VAS scores at the first 30 min were 65.21\u00b19.46 in group 1, 51.86\u00b15.96 in group 2, and 29.33\u00b18.55 in group 3 (p&lt;0.001). The mean VAS scores at the first 1 h were 64.43\u00b19.32 in group 1, 47.26\u00b14.77 in group 2, and 31.66\u00b17.37 in group 3 (p&lt;0.001). The mean scores at the 2 h were 61.46\u00b18.62 in group 1, 48.33\u00b14.66 in group 2, and 30.83\u00b16.76 in group 3 (p&lt;0.001). The mean scores at the 4 h were 64.72\u00b18.91 in group 1, 47.53\u00b14.35 in group 2, and 34.36\u00b16.64 in group 3 (p&lt;0.001). The differences were not significant at 6 h between group 2 (44.91\u00b14.12) and group 3 (41.83\u00b16.71) (p&gt;0.001). However, the values were significantly lower than those of the control group (63.56\u00b19.73) (p&lt;0.001). In addition, VAS scores at all follow-up times were significantly higher in the control group compared with the other groups (p&lt;0.001).\n\nConclusion: Evidence from this study revealed that the combined injection of bupivacaine is more effective than its periarticular injection alone and provides effective post-operative pain management after TKA.\n\nLevel of Evidence: Level I, Therapeutic study\n\nCite this article as: Altay N, Sar\u0131kaya B, Karahan MA, et al. Comparison of efficacy between combined periarticular and incisional injections versus periarticular injection alone of bupivacaine for pain control after total knee arthroplasty: A prospective randomized controlled trial. Acta Orthop Traumatol Turc 2020; 54(4): 402-7.<\/jats:p>","DOI":"10.5152\/j.aott.2020.20212","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T05:35:29Z","timestamp":1591940129000},"page":"402-407","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of efficacy between combined periarticular and incisional injections versus periarticular injection alone of bupivacaine for pain control after total knee arthroplasty: A prospective randomized controlled trial"],"prefix":"10.5152","volume":"54","author":[{"given":"Nuray","family":"Altay","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baran","family":"Sar\u0131kaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmut Alp","family":"Karahan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evren","family":"B\u00fcy\u00fckf\u0131rat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orhan","family":"Binici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cemil","family":"Ert\u00fcrk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Akif","family":"Altay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,6,12]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/3584\/3530","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:52:16Z","timestamp":1763463136000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/3584"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,12]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,1,4]]}},"URL":"https:\/\/doi.org\/10.5152\/j.aott.2020.20212","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"type":"electronic","value":"2589-1294"},{"type":"print","value":"1017-995X"}],"subject":[],"published":{"date-parts":[[2020,6,12]]}}}