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On of the issues after knee replacement surgery is pain and inflammation. In 2012, we did a randomised controlled trial on knee replacements. Prior to that, we had a standardised drug mixture we used around the knee joint of Naropin (ropivicaine), Torodol (ketorolac), and adrenaline. It required one extra blood test at twelve days, and was not a problem for our patients.

The primary outcome was the reduction in CRP, a blood parameter indicating inflammation in the body.  We demonstrated a substantial reduction in CRP, although didn’t prove a reduction in length of stay.

As a result of this study, David Mitchell’s standard knee replacement plan involves doing knee replacements without intramedullary navigation, without tourniquets, and with dexamethasone as part of the drug mixture used around the knee.