Three years ago I had my first knee replacement. I was still living on my own in Chicago. I had the latest surgery there with control of my own pain medication after the operation. Now I’ve moved to New York to live with my son. I’m going to have my other knee replaced. They use a different method of pain control here called a cocktail injection. Will this method work okay?

This cocktail injection is the latest development in pain control after total knee replacement (TKR). Up until now, patient-controlled analgesia (PCA) has been the latest break through.

PCA allows the patient to push a button and release a small amount of narcotic (pain killer) into the blood stream. It’s set up on a timer so the person can’t take too much. PCA has allowed for better pain control and improved rehab.

The cocktail you are referring to is a combination of several drugs. This includes a numbing agent called Marcaine. It’s very similar to Novocaine. The cocktail also includes an antibiotic, steroid, and morphine (a narcotic drug).

The cocktail is injected in two parts. The first injection goes into the joint capsule before putting the new joint liner in place. The second injection goes into the periarticular (around the joint) soft tissues after the knee implant is in place. The synovium, muscles, and ligaments are injected.

According to the early results, this periarticular cocktail injection speeds up recovery. Patients are able to perform a straight leg raise sooner than when using the PCA. More patients go home sooner after the cocktail method of pain control.

If you did well with the PCA approach, it’s likely you’ll do even better with this new method.