Dr. Pugely and coauthors from the University of Iowa published an article in the February edition of The Journal of Bone and Joint Surgery comparing spinal anesthesia to general anesthetic for total knee arthroplasty. They found that patients who underwent a spinal anesthetic had fewer complications, including lower rate of wound infection, blood transfusion, length of stay, and confusion postoperatively. This data supports our belief that use of regional anesthetic such as a spinal in association with a femoral nerve block provides more rapid recovery with lower risk of complications for our total knee patients. Patients are sedated during the operation with a short-acting medication that reverses as soon as the medication is stopped. The combination of this type of anesthesia plus multimodal pain management decreases the pain experienced by patients after hip and knee replacement and allows individuals to get up and around on the day of surgery. By improving the patient experience, which includes postoperative pain management, we have made total joint replacement a more enjoyable experience, which gets the patient back on their feet and returning to activities.
—William P. Barrett, MD
