Early Clinical Outcomes of Dual Subsartorial Block Following Total Knee Arthroplasty in an ERAS Protocol: A Descriptive Study

Abstract

Background: Effective postoperative pain management after total knee arthroplasty (TKA) is essential to facilitate early mobilization and recovery within enhanced recovery after surgery (ERAS) protocols. Dual subsartorial block (DSB) is a regional analgesic technique designed to provide procedure-specific analgesia while potentially preserving motor function. Objectives: This study aimed to describe postoperative pain, assessed using the visual analog scale (VAS) at 24 and 48 hours, as the primary outcome, and early functional outcomes as secondary outcomes, including performance on the Timed Up and Go test, knee flexion range of motion (ROM), and length of hospital stay, in patients undergoing TKA who received DSB within an ERAS protocol. Methods: This retrospective descriptive study included 20 patients who underwent primary TKA between August 2021 and January 2022 at Dr. Soeradji Tirtonegoro Hospital, Klaten, Indonesia. Routine clinical records were reviewed for static and dynamic VAS scores at 24 and 48 hours; TUG results and knee flexion ROM on postoperative days 1 and 2; and LOS. Some outcome records were incomplete, and outcome-specific denominators could not be reliably reconstructed from the archived records. Available values are summarized descriptively; missing values were not imputed. Results: Among the values available in the records, the mean static VAS score was 2.26 ± 1.098 at 24 hours and 1.53 ± 0.964 at 48 hours; the mean dynamic VAS score was 3.47 ± 1.504 and 2.21 ± 1.084, respectively. Mean Timed Up and Go time was 53.501 ± 12.269 seconds on postoperative day 1 and 48.968 ± 13.609 seconds on day 2. Mean knee flexion ROM was 75.25° ± 18.244 on day 1 and 96.25° ± 13.365 on day 2. Mean length of hospital stay was 3.11 ± 1.449 days. Because outcome-specific denominators were not recoverable and participant-level paired data were unavailable, no inferential comparisons between time points are reported. Conclusions: Patients receiving DSB within an ERAS protocol had low postoperative pain scores and showed improvements in early functional measures during the assessed postoperative period. Because this was a descriptive study without a control group, the observed outcomes cannot be attributed specifically to DSB. Prospective comparative studies with larger sample sizes are needed to evaluate the effectiveness of DSB relative to other postoperative analgesic techniques.