Surgery
thromboembolic, TKA
INFILTRATION
TKA was performed with the Rosa® Knee System (Zimmer Biomet, Warsaw, IN, USA) using the Persona® Knee implant. Surgery was performed under spinal anaesthesia along with an adductor canal block and local anaesthetic infiltration. Antibiotics (2 g cefazolin) and tranexamic acid (1 g) were given at the time of induction and continued for 24 h post-operatively. Both groups followed the same post-operative multimodal analgesia regime, with patients receiving standardised post-operative analgesia which included paracetamol (1 g 6 hourly), non-steroidal anti-inflammatories (200 mg celecoxib 12 hourly), if tolerated, and slow-release (SR) opioid-based medication with top-up opioid analgesia as needed. Patients primarily received 50–100 mg of tapentadol SR along with immediate-release (IR) tapentadol. Where this was not tolerated, it was substituted for oxycodone with naloxone SR and oxycodone IR. Dressings were applied after wound closure which remained intact for 2 weeks following surgery and compressive crepe bandaging was applied in theatre, which was removed the following day. Both groups were able to fully weight bear on day one and followed the same standardised rehabilitation protocol guided by the in-patient physiotherapy team, along with routine day one post-operative x-rays, bloods and thromboembolic prophylaxis.