General health and knee function outcomes from 7 days to 12 weeks after spinal anesthesia and multimodal analgesia for anterior cruciate ligament reconstruction

Anesth Analg. 2009 Apr;108(4):1296-302. doi: 10.1213/ane.0b013e318198d46e.

Abstract

Background: We previously reported that continuous perineural femoral analgesia reduces pain with movement during the first 2 days after anterior cruciate ligament reconstruction (ACLR, n = 270), when compared with multimodal analgesia and placebo perineural femoral infusion. We now report the prospectively collected general health and knee function outcomes in the 7 days to 12 wk after surgery in these same patients.

Methods: At three points during 12 wk after ACLR surgery, patients completed the SF-36 General Health Survey, and the Knee Outcome Survey (KOS). Generalized Estimating Equations were implemented to evaluate the association between patient-reported survey outcomes and (1) preoperative baseline survey scores, (2) time after surgery, and (3) three nerve block treatment groups.

Results: Two hundred seventeen patients' data were complete for analysis. In univariate and multiple regression Generalized Estimating Equations models, nerve block treatment group was not associated with SF-36 and KOS scores after surgery (all with P > or = 0.05). The models showed that the physical component summary of the SF-36 (P < 0.0001) and the KOS total score (P < 0.0001) increased (improved) over time after surgery and were also influenced by baseline scores.

Conclusions: After spinal anesthesia and multimodal analgesia for ACLR, the nerve block treatment group did not predict SF-36 or knee function outcomes from 7 days to 12 wk after surgery. Further research is needed to determine whether these conclusions also apply to a nonstandardized anesthetic, or one that includes general anesthesia and/or high-dose opioid analgesia.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia / methods*
  • Analgesics, Opioid / administration & dosage*
  • Anesthesia, Spinal*
  • Anterior Cruciate Ligament / innervation
  • Anterior Cruciate Ligament / physiopathology
  • Anterior Cruciate Ligament / surgery*
  • Catheterization
  • Female
  • Femoral Nerve*
  • Humans
  • Infusions, Parenteral
  • Knee Joint / innervation
  • Knee Joint / physiopathology
  • Knee Joint / surgery*
  • Male
  • Nerve Block*
  • Orthopedic Procedures*
  • Pain Measurement
  • Pain, Postoperative / prevention & control
  • Prospective Studies
  • Recovery of Function
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome

Substances

  • Analgesics, Opioid