Mapping the scientific landscape of regional analgesia for total knee arthroplasty: A bibliometric study.
- 1Department of Anaesthesiology, Ibra Hospital, Ibra, Sultanate of Oman.
- 2Department of Orthopaedics, Ibra Hospital, Ibra, Sultanate of Oman.
- 3Department of Anaesthesiology and Perioperative Care, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, Tamil Nadu, India.
Abstract
Background
Total knee arthroplasty (TKA) is associated with significant postoperative pain, and regional anesthesia (RA)-based analgesic strategies have evolved substantially over the past three decades. Understanding the intellectual structure, influential publications, and thematic evolution of analgesic techniques for TKA is essential to contextualize current practice and guide future research.Methods
A bibliometric analysis was conducted using the Scopus database. Publications related to analgesic strategies and RA for TKA published between 1998 and 2026 were retrieved and analyzed. Data were exported in BibTeX and comma-separated values (CSV) formats and analyzed using the Bibliometrix package (R-Studio: Posit PBC, Massachusetts, United States) and visualization of similarity (VOS) viewer. Bibliometric indicators included annual publication trends, citation analysis, prolific authors, institutions, countries, journals, keyword co-occurrence, thematic evolution, and co-citation networks to identify highly cited and landmark publications.Results
A total of 288 publications were included. Annual scientific output demonstrated a steady increase, with a marked surge after 2013. Early highly cited literature focused predominantly on neuraxial techniques and femoral nerve block-based analgesia. From 2013 onward, a distinct shift toward motor-sparing strategies was observed, coinciding with landmark publications on the adductor canal block. More recent research emphasized multimodal and anatomy-driven approaches, including adductor canal block-based bundles, posterior knee pain management strategies, and periarticular infiltration (PAI) techniques. Citation and co-citation analyses identified a small number of highly influential publications that shaped successive phases of analgesic strategy evolution in TKA.Conclusions
This bibliometric analysis demonstrates a clear temporal evolution of analgesic strategies for TKA, progressing from neuraxial and femoral nerve-dominant paradigms toward motor-sparing and multimodal RA techniques. A limited number of landmark publications have disproportionately influenced this transition. These findings provide a macroscopic overview of research trends, highlight foundational evidence underpinning current practice, and identify areas for future investigation in TKA analgesia.
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BibTeX
@article{nair2026mapping,
title = {{Mapping the scientific landscape of regional analgesia for total knee arthroplasty: A bibliometric study.}},
author = {Abhijit Sukumaran Nair and Saleh Al Sawafi and Sandesh Madi Sural and Areej Al Batrani and Tuhin Mistry},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_162_26},
url = {https://europepmc.org/article/MED/42960337},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Mapping the scientific landscape of regional analgesia for total knee arthroplasty: A bibliometric study.
AU - Abhijit Sukumaran Nair
AU - Saleh Al Sawafi
AU - Sandesh Madi Sural
AU - Areej Al Batrani
AU - Tuhin Mistry
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_162_26
UR - https://europepmc.org/article/MED/42960337
AB - Background Total knee arthroplasty (TKA) is associated with significant postoperative pain, and regional anesthesia (RA)-based analgesic strategies have evolved substantially over the past three decades. Understanding the intellectual structure, influential publications, and thematic evolution of analgesic techniques for TKA is essential to contextualize current practice and guide future research.Methods A bibliometric analysis was conducted using the Scopus database. Publications related to analgesic strategies and RA for TKA published between 1998 and 2026 were retrieved and analyzed. Data were exported in BibTeX and comma-separated values (CSV) formats and analyzed using the Bibliometrix package (R-Studio: Posit PBC, Massachusetts, United States) and visualization of similarity (VOS) viewer. Bibliometric indicators included annual publication trends, citation analysis, prolific authors, institutions, countries, journals, keyword co-occurrence, thematic evolution, and co-citation networks to identify highly cited and landmark publications.Results A total of 288 publications were included. Annual scientific output demonstrated a steady increase, with a marked surge after 2013. Early highly cited literature focused predominantly on neuraxial techniques and femoral nerve block-based analgesia. From 2013 onward, a distinct shift toward motor-sparing strategies was observed, coinciding with landmark publications on the adductor canal block. More recent research emphasized multimodal and anatomy-driven approaches, including adductor canal block-based bundles, posterior knee pain management strategies, and periarticular infiltration (PAI) techniques. Citation and co-citation analyses identified a small number of highly influential publications that shaped successive phases of analgesic strategy evolution in TKA.Conclusions This bibliometric analysis demonstrates a clear temporal evolution of analgesic strategies for TKA, progressing from neuraxial and femoral nerve-dominant paradigms toward motor-sparing and multimodal RA techniques. A limited number of landmark publications have disproportionately influenced this transition. These findings provide a macroscopic overview of research trends, highlight foundational evidence underpinning current practice, and identify areas for future investigation in TKA analgesia.
SN - 1658-354X
SN - 0975-3125
ER -