Bone & Joint Open · IF 2.8 · Jul 21, 2026 · LoE I
Comparative efficacy of analgesic techniques in total hip arthroplasty
This network meta-analysis pooled 112 randomized trials to compare pain-control techniques (nerve blocks, periarticular injection, intrathecal morphine, and combinations) after total hip arthroplasty, using minimal clinically important difference (MCID) thresholds rather than statistical significance alone. No single technique produced a clinically meaningful reduction in postoperative day 1 pain scores, though intrathecal morphine (ITM) and iliopsoas block plus periarticular infiltration reduced 24-hour opioid consumption, and the pericapsular nerve group (PENG) block and ITM shortened hospital length of stay.
AI summary · from the full text
Why it mattersThis challenges current PROSPECT guideline recommendations by showing that many widely used blocks for THA do not clear the bar for clinically meaningful pain relief, which should reshape how residents think about perioperative analgesia choices.
Contradicts current practice and patient-important outcome, offset by effect below the MCID on VAS pain score (0-10) and 24-hour opioid consumption (mg mor and no power calculation.