Use of Liposomal Bupivacaine Instead of an Epidural Can Improve Outcomes Following Total Knee Arthroplasty


The purpose of this study was to compare periarticular injection of liposomal bupivacaine (LB) to epidural analgesia as part of multimodal pain management strategy for total knee arthroplasty (TKA). A retrospective review of 50 patients undergoing TKA compared 25 patients who received LB to 25 patients who received an epidural. After postoperative day 1, patients who received LB exhibited significantly lower (p<.001) pain scores than those who received an epidural. Patients who received LB also had a significantly shorter length of hospital stay (p<.0001), greater range of motion on postoperative day 1, and walked significantly farther (p<.001) on postoperative day 1. LB appears to provide effective pain control leading to shorter hospital stays and improved early physical function compared with standard pain management with an epidural. (Journal of Surgical Orthopaedic Advances 24(4):230–234, 2015) Key words: liposomal bupivacaine, pain management, periarticular injection, total knee arthroplasty

Eric A. Heim, MD; A. Jordan Grier, BS; Robert J. Butler, DPT, PhD; Marty Bushmiaer, APN; Robin M. Queen, PhD; C. Lowry Barnes, MD