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Single-Shot Femoral Nerve Block Versus Local Infiltration Analgesia For Patients Undergoing Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

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Single-Shot Femoral Nerve Block Versus Local Infiltration Analgesia For Patients Undergoing Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

André Richard Da Silva Oliveira Filho, Student, BRAZIL Elcio Machinski, md, BRAZIL Vinícius Furtado, Student, BRAZIL Rodrigo Conde, MS, ARGENTINA Bruno Butturi Varone, MD, BRAZIL Riccardo Gomes Gobbi, MD, PhD, BRAZIL Camilo P. Helito, MD, PhD, Prof, BRAZIL Daniel Leal, MD, BRAZIL

Universidade de São Paulo (USP), São Paulo, São Paulo, BRAZIL

2025 Congress ePoster Presentation 2025 Congress Not yet rated

Anatomic Location

Knee

Treatment / Technique

Arthroplasty

Summary: FNB vs LIA for TKA

ntroduction
Total knee arthroplasty (TKA) is a common surgical procedure with a rising prevalence, particularly due to an aging population. Early postoperative rehabilitation is crucial for favorable long-term outcomes, necessitating effective analgesic strategies. Femoral nerve block (FNB) and local infiltration analgesia (LIA) are widely utilized for pain management. However, the relative efficacy of single-shot femoral nerve block (sFNB) versus LIA remains unclear due to mixed study results. This study aims to conduct a systematic review and meta-analysis to address these uncertainties.

Methods

This systematic review and meta-analysis adhered to Cochrane and PRISMA guidelines, focusing exclusively on prospective randomized clinical trials (RCTs) that compared sFNB with LIA in TKA patients. A comprehensive literature search was performed using Medline, Cochrane Library, and Embase databases. Data were extracted on postoperative pain scores, opioid consumption, length of hospital stay, nausea and vomiting. The mean differences (MD) and risk ratios (RR) were pooled with 95% confidence intervals (CI) for continuous and categorical outcomes, respectively. Heterogeneity was assessed by I2 statistics. The RoB2 tool was employed to evaluate the risk of bias. Subgroup analyses were performed for studies that included epinephrine, morphine, or ketorolac in the LIA drug cocktail.

Results

The systematic search yielded 922 studies, of which 12 RCTs were included in the meta-analysis, encompassing a total of 1,161 patients - 577 in the LIA group and 584 in the sFNB group. There were no statistically significant differences between the groups in terms of pain scores on postoperative day (POD) 1 at rest (MD = 0.19; 95% CI: -0.22 to 0.61; p = 0.36; I² = 58%), on POD 2 at rest (MD = 0.07; 95% CI: -0.30 to 0.44; p = 0.71; I² = 19%), on POD 1 during mobilization (MD = 0.07; 95% CI: -0.94 to 1.08; p = 0.88; I² = 81%) and on POD2 during mobilization (MD = -0.09; 95% CI: -0.25 to 0.08; p = 0.88; I² = 81%). Also, there was no difference in opioid consumption on POD 1 (MD = 0.27 mg; 95% CI: -3.22 to 3.76; p = 0.88; I² = 83%), on POD 2 (MD = -0.34 mg; 95% CI: -1.01 to 0.34; p = 0.33; I² = 0%) and in incidence of nausea (RR = 0.94; 95% CI: 0.60 to 1.46; p = 0.783; I² = 0%) between sFNB and LIA. However, the LIA group showed a statistically significant reduction in length of hospital stay (MD = -0.23; 95% CI: -0.06 to -0.41; p < 0.01; I² = 0%). The subgroup analyses were consistent with the overall non-statistically significant trend.

Conclusions

The LIA group demonstrated shorter hospital stays compared to the sFNB group. However, the reduction was approximately six hours, which may not be clinically meaningful. Additionally, no significant differences were observed between the groups in postoperative pain scores, opioid consumption, or the incidence of nausea and vomiting.

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Robot Assisted Total Knee Arthroplasty and Navigation Assisted Total Knee Arthroplasty : A Comparative study with a focus on Severe Varus Deformities. ePoster Presentation Rajesh Maniar, INDIA Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ishan Khanna, MBBS, MS, INDIA Pranav Shere, MS,DNB , INDIA Anish Nandkumar Tawde, M. S. Orthopaedics , INDIA
Is It Really Worth Changing From Computer Navigation to Robotic Knee Replacement? A Prospective Study to Compare Patient Outcomes Following Robotic-Assisted and Computer-Navigated TKA ePoster Presentation Jacob O'Brien, B. Physiotherapy (Hons), AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Harbeer Ahedi, PhD Biomedical Sciences, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA
A Different Course Of Recovery For Extension And Flexion Strengths Following Total And Unicompartmental Knee Arthroplasty: A Prospective Cohort Study Of 369 Cases ePoster Presentation Roderick J.M. Vossen, MD, UNITED STATES Joyce L. Benner, PhD, NETHERLANDS Gaby Victoria Ten Noever De Brauw, NETHERLANDS Gino M. M. J. Kerkhoffs, MD, PhD, Prof., NETHERLANDS Andrew D. Pearle, MD, UNITED STATES Hendrik Aernout Zuiderbaan, MD PhD, NETHERLANDS Lucien C.M. Keijser, MD PhD, NETHERLANDS
Conversion To Total Knee Arthroplasty Following High Tibial Osteotomy And Unicompartmental Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation Griffith G. Gosnell, MS, UNITED STATES Katherine L. Esser, BS, UNITED STATES Michael Moore, BA, UNITED STATES Nathaniel P. Mercer, MD, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Laith M. Jazrawi, MD, UNITED STATES Eric Strauss, UNITED STATES Michael J Alaia, MD, UNITED STATES
Early Clinical Outcome In Inverse Kinematic Alignment For Total Knee Arthroplasty Using A Robotic Assisted System: Two Years Follow-Up ePoster Presentation Federica Manca, MD, ITALY Leo Massari, Prof., ITALY Alberto Belluati, MD, ITALY Andrea Colombelli, MD, ITALY
Novel Algorithm for Gap Balancing and Bone Cuts in Robotic Total Knee Replacements Significantly Improves Accuracy and Surgical Duration ePoster Presentation Glen Liau , MBBS, MRCS, MMed, FRCS, FAMS, MBA, SINGAPORE Matthew Song Peng Ng, MBBS, SINGAPORE Ryan Wai Keong Loke, MBBS candidate, SINGAPORE
Changing amount of posterior tibial slope during unicompartmental knee arthroplasty does not affect short-term postoperative patients reported outcome measurement ePoster Presentation Ryo Tomita, MD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Hikaru Kristi Ishibashi, MD, JAPAN Hitoshi Kudo, PhD, JAPAN Hironori Otsuka, MD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Yukiko Sakamoto, MD, PhD, JAPAN Yuka Kimura, MD, PhD, JAPAN Yasuyuki Ishibashi, MD, JAPAN
EARLY LOOSENING OF THE FEMORAL STEM IN CEMENTED SEGMENTAL PROSTHESES WITH DISTAL FEMUR REPLACEMENT ePoster Presentation Clara Chimeno Pigrau, MD, SPAIN Marta Sabater Martos, Md, SPAIN Mariano Balaguer-Castro, MD, MSc, PhD, SPAIN Marc Ferrer Banús, MD, SPAIN Montserrat Monfort Mira, MD, SPAIN Dragos Popescu, MD, PhD, SPAIN Salvi Prat, SPAIN Joan Sugrañes, SPAIN Juan C. Martinez-Pastor, MD, SPAIN
Comparison Of Outcomes Of Revision Uka To Tka And Primary Tkas -A Propensity Matched Study. ePoster Presentation Myles R. J. Coolican, FRACS, AUSTRALIA Harbeer Ahedi, PhD Biomedical Sciences, AUSTRALIA
A Novel Knee Intra-Operative Classification Of Osteo-Arthritis (KICO) ePoster Presentation Geoffrey Murphy, MD, AUSTRALIA Simon Luc Edmond Walgrave, MD, BELGIUM Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA
Bone Resection Planning for Medial Uka Using Stress Views is Efficient: Protocol Validation Using an Image-Based Robotic System ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Constant Foissey, MD, FRANCE Valentina Rossi, MD, ITALY Cécile Batailler, MD, PhD, FRANCE Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Elvire Servien, MD, PhD, Prof., FRANCE Sebastien Lustig, MD, PhD, Prof., FRANCE
Soft Tissue Balancing In Robotic-Assisted Total Knee Arthroplasty ePoster Presentation Tomoya Takasago, MD, PhD, JAPAN Katsutoshi Miyatake, MD, PhD, JAPAN Akihiro Nagamachi, MD, PhD, JAPAN
Knees With Lateral Compartment Osteoarthritis Show A Substantial Variability In Functional Knee Phenotypes With Gender-Specific And Age-Related Differences: Phenotypic Analysis Of 305 Knees ePoster Presentation Gaby Victoria Ten Noever De Brauw, NETHERLANDS Tarik Bayoumi, MD, NETHERLANDS Lindsey Ruderman, BA, UNITED STATES Gino M. M. J. Kerkhoffs, MD, PhD, Prof., NETHERLANDS Hendrik Aernout Zuiderbaan, MD PhD, NETHERLANDS Andrew D. Pearle, MD, UNITED STATES
The Use Of Imageless Robotic Assistance Does Not Reduce Early Postoperative Pain In Total Knee Replacement Compared To Conventional Arthroplasty ePoster Presentation Rodrigo Olivieri, MD, CHILE Sebastian Bianchi, MD, CHILE Cristóbal Díaz, MD, CHILE Pablo Albornoz, MD, CHILE Victor Barrientos, PhD, CHILE Jaime Ignacio Ugarte Checura, MD, CHILE Carolina Cardemil, MD, CHILE Pilar Buendia, BSN, CHILE Nicolas Franulic, MD, CHILE Jose Ignacio Laso, MD, CHILE Nicolas Gaggero, MD, CHILE
The Effect Of Excessive Alignment Correction And Limb Length Discrepancy After Total Knee Arthroplasty On Contralateral Lower Extremity Alignment And Knee Condition ePoster Presentation Seung Hoon Lee, MD, KOREA, REPUBLIC OF
ArthroPredict: A Machine Learning Approach To Predict 5-Year Total Joint Replacement In Patients With Osteoarthritis Using Routine Clinical Data ePoster Presentation Ahmed Elgebaly, MD, PhD, UNITED KINGDOM Atef Abdelrahman Hassan, MD, EGYPT Rawad K M Hammad, MD, UNITED KINGDOM Hassan Abdalla, MD, UNITED KINGDOM Mohamed A. Imam, MD, MSc, DSportMed, ELD (Oxon), PhD, FRCS, UNITED KINGDOM
Oxford Partial Knee Femoral Sizing Via Preoperative Mri Scan – A Novel Template Method ePoster Presentation Ritwik Kejriwal, FRACS(Orth), NEW ZEALAND
Factors Affecting Final Saggital Alignment In Robotic Total Knee Replacement ePoster Presentation George Jacob, MBBS, MS Ortho, FAOrthA, INDIA Yoong Lim, BEng, PhD, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA
Predictors of High Oxford Knee Scores at 1 year Following TKR - Analysis of 4126 knees at a Single Centre ePoster Presentation Payam Tarassoli, MBChB, BSc, DipSEM, MD, FRCS, AUSTRALIA Yoong Lim, BEng, PhD, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA
Anatomical investigation of the popliteal artery in unicompartmental knee arthroplasty cases ePoster Presentation Naoto Date, MD, JAPAN Masaki Mori, MD, PhD, JAPAN Kengo Kaji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN
Robotic-Assisted Total Knee Arthroplasty Achieves Superior Accuracy In Restoring Native Posterior Femoral Condylar Offset And Tibial Slope Compared To Conventional Technique ePoster Presentation Lika Dzidzishvili, MD, PhD, SPAIN Ester Garcia-Oltra, MD, PhD, SPAIN Francisco Aliaga, M.D, PhD, SPAIN Vicente López, SPAIN José Antonio Hernández-Hermoso, MD, PhD, SPAIN
Patellar Alignment In Robotic-Assisted Total Knee Arthroplasty. ePoster Presentation David H. Figueroa, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Javier Ignacio González, MD, CHILE Mario Eduardo Mora Valdés, MD, CHILE Daniel Alvarez, MD, CHILE
Evaluating Tibial Component Rotational Alignment After Total Knee Arthroplasty Using Augmented Reality Navigation System With Smart Glasses ePoster Presentation Takayuki Koya, MD, PhD, JAPAN Atsushi Sato, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Misako Takizawa, MD, JAPAN Reo Nagasaka, JAPAN Marika Mukunoki, MD, JAPAN Kanako Izukashi, MD, JAPAN Jun Oike, MD, PhD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Saki Yagura, MD, JAPAN Koji Kanzaki, Prof., JAPAN
Influence of Femorotibial Posterior Overhang and Posterior Tibial Slope on Patellar Changes After TKA ePoster Presentation Shunsuke Utsumi, MD, JAPAN Takashi Aki, PhD, JAPAN Masayuki Kamimura, JAPAN Kento Harada, MD, JAPAN Toshimi Aizawa, JAPAN
The Mind Matters: Psychological Factors Influence Subjective Outcomes Following Unicompartmental Knee Arthroplasty - A Prospective Study ePoster Presentation Gaby Victoria Ten Noever De Brauw, NETHERLANDS Margot B. Aalders, MD, NETHERLANDS Hendrik Aernout Zuiderbaan, MD PhD, NETHERLANDS Lucien C.M. Keijser, MD PhD, NETHERLANDS Joyce L. Benner, PhD, NETHERLANDS
Short-term Outcomes of Robotic-Assisted Restricted Kinematic Alignment vs Mechanical Alignment in Unilateral Total Knee Arthroplasty ePoster Presentation Eiichi Shiigi, MD、PhD, JAPAN
Two-Year Results Of The Kneefix Study: A Randomised Controlled Trial Comparing Uncemented Versus Cemented Fixation In Total Knee Arthroplasty With Patella Resurfacing ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Bill Farrington, FRCS, NEW ZEALAND Rupert S Van Rooyen, MBChB, FRACS, NEW ZEALAND Mei Lin Tay, PhD, NEW ZEALAND Matthew Walker, MBChB, FRACS, NEW ZEALAND Ali Bayan, MBChB, FRACS, NEW ZEALAND
Mid-Term Outcomes Of Lateral Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Sumin Lim, MD, PhD, KOREA, REPUBLIC OF Jun-Young Chung, MD, KOREA, REPUBLIC OF Tae Hun Kim, MD, KOREA, REPUBLIC OF Myung-Sub Lee, MD, KOREA, REPUBLIC OF Jeong-Hyun Koh, MD, KOREA, REPUBLIC OF Jeong Sunwoo, MD, KOREA, REPUBLIC OF
Impact of Preoperative Limb Alignment and Deformity on Postoperative Limb Alignment in Unicompartmental Knee Arthroplasty ePoster Presentation Takashi Ishitani, MD, JAPAN Shuhei Otsuki, MD, JAPAN Yoshinori Okamoto, MD, PhD, JAPAN
High ten years survivorship and functional results of robotic-arm-assisted lateral unicompartmental knee arthroplasty ePoster Presentation Guido Maritan, MD, ITALY Mattia Berti, MD, ITALY Federico Roman, MD, ITALY Emanuele Furlan, MD, ITALY
Is Bi-Cruciate Stabilized Total Knee Arthroplasty Better Than Conventional Knee Arthroplasty In Knee Biomechanics During Gait? ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Kazuya Kaneda, MD, PhD, JAPAN Tatsuaki Matsumoto, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
Soft Tissue Safety In Robotic-Assisted Total Knee Arthroplasty: Is It Reliable? ePoster Presentation Eric Camprubí, MD, SPAIN Juan Ignacio Erquicia, MD, PhD, SPAIN Berta Gasol Cudos, MD, SPAIN Albert Pons Riverola, MD, SPAIN Angela Zumel, PhD, SPAIN Joan Leal-Blanquet, MD, PhD, SPAIN
Increased Patient Travel Distance for Revision Total Knee Arthroplasty is Associated With a Higher Re-revision Rate ePoster Presentation Logan Finger, MD, UNITED STATES Yunseo Linda Park, BS, UNITED STATES Matthew Como, BS, UNITED STATES Akeem Williams, BS, UNITED STATES Kenneth Urish, MD, PhD Michael O'Malley, MD, UNITED STATES Brian Klatt, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES
Use of Patient-Specific 3D-Printed Intraoperative Spacers in Complex Revision Total Knee Arthroplasty. Surgical Technique and Preliminary Results. ePoster Presentation Giulio Vittone, MD, ITALY Marcello Motta, MD, ITALY Marco Adriani, MD, ITALY Alberto Guizzi, ITALY Alessandro Colosio, MD, ITALY Giuseppe Milano, Prof., ITALY
An Isakos Funded Study - Physical Activity Outcomes In Patellofemoral Vs. Total Knee Replacements: A Randomised Control Trial For Isolated Patellofemoral Joint Osteoarthritis . ePoster Presentation Martinique Vella-Baldacchino, MD, MRCS, PG CERT (HEALTH LEADERSHIP), IOC DIp Spo, UNITED KINGDOM Julie Heegaard, MD, DENMARK Snorre Stephensen, MD, DENMARK Soeren Rytter , MD, DENMARK Per Wagner Kristensen, MD, DENMARK Zahid Asghar , PhD, UNITED KINGDOM Alex D Liddle, MBBS BSc DPhil FRCS(Orth), UNITED KINGDOM Justin Cobb, MCh FRCS, UNITED KINGDOM Anders Odgaard, DENMARK
Operator variation in applying the AtMoves knee loading device for evaluation of tibial component loosening ePoster Presentation George Samuel Buijs, MD, NETHERLANDS Maaike Annemiek ter Wee, MSc, NETHERLANDS Chiel Klein, BSc, NETHERLANDS Lidwine B. Mokkink, PhD, NETHERLANDS Johannes Dobbe, PhD, NETHERLANDS Mario Maas, MD, PhD, NETHERLANDS Matthias U. Schafroth, MD, NETHERLANDS Geert Streekstra, PhD, NETHERLANDS Leendert Blankevoort, PhD, NETHERLANDS Arthur Johan Kievit, MD, NETHERLANDS
Robotic-Assisted Total Knee Arthroplasty is Associated With Shorter Surgical Time and Length of Stay and Decreased Risk for Revision ePoster Presentation Logan Finger, MD, UNITED STATES Nicolas Aycardi, BS, UNITED STATES Akeem Williams, BS, UNITED STATES Yunseo Linda Park, BS, UNITED STATES Kenneth Urish, MD, PhD Michael O'Malley, MD, UNITED STATES Brian Klatt, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES
Changes in the Posterior Tibial Slope among Patients undergoing Medial Unicompartmental Knee Arthroplasty do not affect the Medial Proximal Tibial Angle ePoster Presentation Lorenz Pichler, MD, AUSTRIA Rosa Berndt, MD, GERMANY Carsten Perka, MD, PhD, GERMANY Clemens Gwinner, MD, GERMANY Moses Kamal Dieter El Kayali, MD, GERMANY
Lateral Laxity is Related to the Postoperative Kinematics and Knee Symptoms After Total Knee Arthroplasty Using Medial Stabilizing Technique with a Navigation System ePoster Presentation Takahiro Tsushima, MD, PhD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Kazuki Oishi, MD, JAPAN Yukiko Sakamoto, MD, PhD, JAPAN Yuka Kimura, MD, PhD, JAPAN Eiichi Tsuda, Prof., JAPAN Yasuyuki Ishibashi, MD, JAPAN
Does Robotic Assistance In Total Knee Arthroplasty Improve Preoperative Planning And Intraoperative Decision-Making? ePoster Presentation David H. Figueroa, MD, CHILE Waldo Gonzalez Duque, MD, CHILE Rafael Calvo, MD, CHILE Francisco Figueroa, MD, CHILE
Catastrophic Full Thickness Wear In Oxinium Knee Implants: A Case Report And Analysis Of Failure Mechanisms ePoster Presentation Naman Wahal, MBBS, MS Orthopaedics, INDIA RAJESH MALHOTRA, MS Orthopaedics, FIMSA, FRCS, FACS, INDIA
A Machine Learning-Powered Decision Tool to Predict the Risk of Knee Arthroplasty in Patients with Osteoarthritis Using Plain Radiographs and Routine Clinical Data ePoster Presentation Ahmed Elgebaly, MD, PhD, UNITED KINGDOM Atef Abdelrahman Hassan, MD, EGYPT Rawad K M Hammad, MD, UNITED KINGDOM Hassan Abdalla, MD, UNITED KINGDOM Mohamed A. Imam, MD, MSc, DSportMed, ELD (Oxon), PhD, FRCS, UNITED KINGDOM
Double-blinded Prospective Randomized Clinical Trial in Total Knee Arthroplasty: Impact of Tourniquet Inflation Timing on Postoperative Pain, Joint Function, and Quality of Life ePoster Presentation Po-Yao Wang, MD, TAIWAN Ting-Chun Lin, TAIWAN Chia-Hui Wang, PhD, TAIWAN Jia-Lin Wu, MD, MS, TAIWAN
Added Utility Of Mri In Pre-Operative Assessment For Medial Unicompartmental Knee Arthroplasty ePoster Presentation Scott M Bolam, MBChB, PhD, NEW ZEALAND Mei Lin Tay, PhD, NEW ZEALAND Laura Hill, MBChB, NEW ZEALAND David Dow, MD, NEW ZEALAND Paul Monk, DPhil (Oxon), FRCS, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND

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Single-Shot Femoral Nerve Block Versus Local Infiltration Analgesia For Patients Undergoing Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

Single-Shot Femoral Nerve Block Versus Local Infiltration Analgesia For Patients Undergoing Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

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Conclusions

Knee Arthroplasty ePosters

Sign-in to ISAKOS

Single-Shot Femoral Nerve Block Versus Local Infiltration Analgesia For Patients Undergoing Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

Single-Shot Femoral Nerve Block Versus Local Infiltration Analgesia For Patients Undergoing Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

Methods

Results

Conclusions