Psoas Compartment Block Versus Periarticular Local Anesthetic for Total Hip Arthroplasty

Psoas Compartment Block Versus Periarticular Local Anesthetic Infiltration for Pain Management for Total Hip Arthroplasty: A Prospective, Randomized Study

The primary objective of this study is to examine whether there is a difference in the level of resting pain following total hip arthroplasty with an anterior approach with use of a psoas compartment block versus a local periarticular anesthetic infiltration

A single-center, prospective, randomized clinical trial with a total of 100 patients. One orthopaedic adult reconstruction surgeon at Beaumont Hospital Royal Oak (JJV) will perform all surgeries. After the patient has consented they will be randomized to one of the following two groups:

1. Psoas compartment block (n=50)
2. Periarticular local anesthetic infiltration (n=50),

The patient will be blinded to the study group.

Inclusion Criteria:

• Patients undergoing unilateral primary total hip arthroplasty by Dr. James Verner at Beaumont Hospital Royal Oak
• Have a diagnosis of primary osteoarthritis (i.e. degenerative joint disease)
• Surgical approach is anterior

Exclusion Criteria:

• Minors (age less than 18 years)
• Pregnant (surgically sterile, post-menopausal, or negative blood test)
• Previous ipsilateral hip surgery
• Lumbar instrumentation
• Acute trauma
• Rheumatoid arthritis
• Avascular necrosis
• Hip dysplasia
• Known sensitivity, allergy, or contraindication to anesthetics being used in the study
• Narcotic sensitivity
• History of over 6 months of opioid dependency prior to surgery (excluding tramadol)
• Peripheral neuropathy
• Mental/cognitive impairment that would interfere with the patient's self-assessments of function, pain, or quality of life