Opioid-free Accelerated Recovery Total Knee Arthroplasty

All study patients will receive a standardized protocol

- All surgical procedures performed by single surgeon using same implants, approach,
pre-op and post-op optimization, and simplified pain protocol at a single hospital or
surgery center

- Will attempt to minimize the number of anesthesiologists to further control variability
in care

Methods:

1. Pre-op Optimization

- All patients enroll in education program

- All patients have optimized BMI, hemoglobin, albumin, glucose control-A1C, and
blood pressure

2. Total Joint Procedure

- Tourniquet-free cemented total knee arthroplasty is performed with intra-articular
block

3. Data Collection

- Electronic medical record chart review

- Pre-op assessment and Post-op assessment (post anesthesia care unit (PACU), Phase
II-prior to discharge

- Phone calls after discharge

- Follow-up assessment in surgeon's office

- Swiftpath / KOOS JR surveys

4. Pain Management Regimen

- pre-op physical therapy teaching

- post-op multimodal pain regimen

Inclusion Criteria:

- Surgeries to be performed at hospital

- Surgeries to be performed at surgery center

- Ability to read and understand English

- Primary care clearance for patients diagnosed with high blood pressure

Exclusion Criteria:

- Disease states, patient conditions to exclude:

Schizophrenia Bipolar Disease Dementia

- Known allergies to local anesthetics

- Previous burn to affected extremity

- BMI > 40

- Nonoptimized anemia

- Albumin less than 3.5

- A1C > 8.0