Analgesia for total hip and knee arthroplasty: a review of lumbar plexus, femoral, and sciatic nerve blocks.

Use of peripheral nerve blocks (PNBs) during lower extremity surgery has evolved. In this article, we review the pertinent anatomy and the literature concerning the advantages and disadvantages of both PNBs and traditional methods of postoperative analgesia (neuraxial and patient-controlled) for total hip arthroplasty and total knee arthroplasty. We conclude that use of PNBs for total hip and total knee arthroplasty compares favorably with traditional methods of postoperative analgesia. As use of PNBs becomes more widespread, understanding their risks and benefits will be of great value to orthopedic surgeons.