Comparison Between Liposomal Bupivacaine and Femoral Nerve Block in Patients Undergoing Primary Total Knee Arthroplasty


This study sought to evaluate opioid consumption, hospitalization costs, and length of stay when
surgical site periarticular infiltration of liposomal bupivacaine is used after total knee arthroplasty (TKA).
Sixty-six consecutive primary TKA cases performed with a single-injection femoral nerve block before this date were compared with 59 consecutive TKA cases performed with the liposomal bupivacaine cocktail after this date. The mean amount of postsurgical opioids consumed was 199 mg versus 121 mg (pD.075), the average hospitalization cost was $28,546 versus $26,472 (p<.001), and the average length of stay was 2.05 days versus 1.58 days (p<.001) in the femoral nerve block versus liposomal bupivacaine group, respectively. There were no significant demographic differences between the two groups. Liposomal bupivacaine infiltration before primary wound closure may be an effective means in lowering hospitalization costs, decreasing length of stay, and decreasing postsurgical opioid consumption after TKA. (Journal of Surgical Orthopaedic Advances 24(4):225–229, 2015) Key words: femoral nerve block, hospitalization costs, length of stay, liposomal bupivacaine (Exparel), patient-controlled analgesia, TKA

Adam J. Cien, DO, MS; Phillip C. Penny, DO, MS; Brandon J. Horn, DO; John M. Popovich, PhD, DPT; Charles J. Taunt, Jr., DO