Table 2.

Categories of Outpatient Knee Surgery for which Unique Regional Anesthesia Care Plans are Likely Beneficial

Category 1: Diagnostic Knee Arthroscopy

Category 2: Surgical Pain Primarily Restricted to the Femoral Nerve Distribution

2a: Duration of Moderate or Severe Pain Typically Restricted to 24 hr or less

Practical Examples:

•   ACL with conventional single-bundle allograft (cadaver)

•   Arthrotomy for Deep Hardware Removal

•   Microfracture

•   Mosaicplasty / Chondroplasty

•   Meniscal repair with fibrin clot

2b. Duration of Moderate or Severe Pain Extending Past 24 hr

Practical Examples:

•   ACL patellar tendon autograft (a.k.a. bone-patellar tendon-bone)

Category 3: Surgical Pain Occurring in both Femoral and Sciatic Nerve Distributions

3a. Least Invasive – Pain in both nerve distributions typically restricted to 24 hr or less

Practical Examples

•   Distal patella realignment

•   Knee manipulation for arthrofibrosis

3b. Moderately Invasive - Pain in the sciatic nerve distributions typically restricted to 24 hr or less, while pain in femoral nerve distribution likely exceeding 24 hr

Practical Examples

•   ACL with single-bundle hamstring autograft (a.k.a, semi-tendinosus – gracilis, or ST-G)

•   ACL with double-bundle allograft

•   Chondrocyte Transplant

•   Medial Patellofemoral Ligament Reconstruction

3b. Most Invasive - Pain in the femoral and sciatic nerve distributions typically exceeding 24 hr

Practical Examples

•   Total Knee Replacement

•   High Tibial Osteotomy

•   Multi-ligament reconstruction including posterior cruciate ligament,             posterior oblique ligament, poeterolateral corner reconstruction

•   Unicompartmental Knee Arthroplasty

•   Meniscal reconstruction

ACLR: anterior cruciate ligament reconstruction