On September 23, 2021, Dr. Nicholas Strasser presented results of a four year clinical trial evaluating pain control after total ankle arthroplasty at the American Orthopaedic Foot & Ankle Society (AOFAS) annual meeting in Charlotte, North Carolina.
The study is titled “Peripheral nerve block compared to intra-articular injection for post-operative pain control in total ankle arthroplasty: A randomized, controlled, non-inferiority trial.” The study evaluated whether intra-articular joint injection, using the medications commonly used in hip and knee arthroplasty procedures, was no worse than a peripheral nerve block for pain control in the first 24 hours and two weeks after surgery. We collected patient pain scores and opioid consumption through medication diaries and compared both between study groups.
Dr. Strasser reports the presentation was very well received by the moderating panel and the audience, as this study is the first prospective trial to compare nerve block to single-shot, intra-articular injection in total ankle patients. While results did not confirm non-inferiority across all measures at 24 hours and 2 weeks based our pre-defined margins, there were no significant difference in mean pain score, opioid consumption, or complications identified between study groups. Further research with greater sample size will likely demonstrate intra-articular injection is no worse than peripheral nerve block for post-operative pain control and avoids potential neuropathic complications associated with peripheral nerve block.
Dr. Strasser performed this study at Slocum between 2016 and 2020 with the help from the study team: Michelle Bremer, John Paul Bigouette, Tessa Kirkpatrick, Cindy Headlee, and Erin Owen. The full manuscript reporting study results will be submitted to Foot & Ankle International, a scientific peer-reviewed journal, in October.