• Sports Traumatology

The thesis is based on four randomized controlled trials. The main hypothesis was that multimodal pain treatment provides faster recovery after arthroscopic surgery.

NSAID was tested against placebo after knee arthroscopy. Intraarticular bupivacaine plus morphine plus steroid was tested against bupivacaine plus morphine and against saline in two trials after arthroscopic knee meniscectomy and diagnostic knee arthroscopy respectively. Intraarticular bupivacaine plus morphine plus steroid was tested against saline after operative ankle arthroscopy.
Oral NSAID reduced time to work from 17 to 14 days after knee arthroscopy.Intra-articular treatment with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after arthroscopic knee meniscectomy reduced time to work from 10 to 5 to 3 days. Intraarticular treatment with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after diagnostic knee arthroscopy reduced time to work from 10 to 5 to 2 days. Additional analysis revealed that the surgical trauma and the use of tourniquet influenced recovery.

The thesis proves a reduction in the time to return to work after knee and ankle arthroscopy with the use of oral NSAIDs combined with bupivacaine plus morphine or combined with bupivacaine, morphine plus steroid.

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