Comparison of Two Multimodal Pain Regimens Used for Postoperative Pain Control in Total Joint Arthroplasty Patients


Postoperative pain control following total joint arthroplasty results in improved patient mobilization,
participation in physical therapy, and potentially reduced hospital costs. It was hypothesized that using a multimodal pain protocol focusing on periarticular injections including liposomal bupivacaine would have improved results when compared with a parenteral opioid-based regimen. The results showed a
decrease in length of stay and rate of discharge to skilled nursing facilities with the implementation of a novel multimodal pain protocol. Furthermore, there was no change in patient satisfaction before and
after the execution of the new protocol. It was concluded that using a multimodal pain protocol based
on periarticular injections can lead to decreased length of stay and a decrease in transfer to skilled
nursing facilities without a change in patient satisfaction. (Journal of Surgical Orthopaedic Advances
25(4):209–214, 2016) Key words: arthroplasty, liposomal bupivacaine, multimodal pain management, opioid, pain management, total hip replacement, total knee replacement

Alexander H. Jinnah, MD; Beth P. Smith, PhD; and Brett C. Perricelli, MD