Regional analgesia in TKA: corrected evidence-reading note

Educational work by a pre-medical student — not medical advice. Not a clinical protocol, prescription, or patient handout, and not for patient care. See DISCLAIMER. The prior companion review's numerical trial summaries and broad non-inferiority claims have not been substantiated in this audit and are not retained as verified results. See the corrected regional section of the main draft.

The key correction concerns the background analgesic regimen: the earlier iPACK discussion reversed the role of periarticular infiltration in the cited synthesis. The cited synthesis found no added benefit when periarticular infiltration was already used. Without it, pain/function findings improved but opioid consumption did not. These findings should not be generalized across regimens, outcomes, or surgical platforms. Similar observed outcomes do not establish equivalence without the appropriate design and margin.

Sources checked

• Schnabel et al., 2019: Cochrane review of adductor canal blocks in adult knee surgery (25 RCTs: 18 TKA, 7 arthroscopic), so not all included trials are TKA.
• Hussain et al., 2021: iPACK synthesis stratified by periarticular infiltration.
• Albrecht et al., 2015: heterogeneous peripheral-block dexamethasone literature.

A full evidence map requires an auditable search, selection record, extraction, and outcome-specific appraisal. Those activities are not replaced by this selected-source correction.