Background: Total knee arthroplasty (TKA) is associated with moderate to severe post-operative pain in approximately 20-30% of patients despite oral and parenteral analgesic use. A novel approach to pain management is to control local pain pathways and receptors within the knee. A safe and cost effective measure of achieving this is by local intra and periarticular injections of cocktail anesthesia. Objective: To compare the efficacy of ropivacaine and bupivacaine in cocktail periarticular injection, in immediate post-operative analgesia and rehabilitation in patients undergoing total knee arthroplasty. Materials and methods: A total of 46 patients undergoing total knee arthroplasty was divided into two groups. Group I received bupivacaine based cocktail regimen and group II received ropivacaine based cocktail regimen. In the post-operative period, both the groups were compared for pain relief and range of knee movements at 12 and 24 hours respectively. Results: In group I, the mean VAS at 12 hours was 8.01±0.38 and at 24 hours was 3.93±1.95 while in group II, the mean VAS at 12 hours was 7.12±0.47 and at 24 hours was 2.09±0.06. Paried 't' test show statistical significant difference in pain relief among both the groups (p< 0.05). Among our study population, the mean range of movements improved in group II with significant statistical difference of p< 0.001 p=0.03. Conclusion:In patients with TKA, Ropivacaine based cocktail regimen has better post-operative pain relief and earlier range of knee movements while comparing with bupivacaine based cocktail regimen.

Aim: of the study was to compare the functional outcome in patients undergoing navigation and conventional total knee replacement. secondly to compare the component alignment in patients undergoing navigation and conventional Total Knee Replacement. Materials and methods: Total 80 patients were included in study out of which 40 patients were in each group. All the surgeries were done by single surgeon and subvastus approach was used for all the total knee replacements. Pre-operative functional assessment was done by KSS score14. Preoperative radiological grading of osteoarthritis was done using AHL back. Post operatively all patients were followed upto 1,3 and 6 months and at the end of 6 months radiological assessment of the components was done by measuring Alpha, beta, gamma and sigma angles. Conclusion: Navigation TKR significantly improves the alignment of both femoral and tibial components when compared with the conventional TKR. However there was no significant difference in functional outcome between the two methods. Probably a long term study might highlight on if navigation has a role in improving the longevity of the implant.