Pain Course after Total Knee Arthroplasty within a Standardized Pain Management Concept: A Prospective Observational Study

Abstract

Background: Joint replacement surgeries have been known to be some of the most painful surgical procedures. Therefore, the options for postoperative pain management are of great importance for patients undergoing total knee arthroplasty (TKA). Despite successful surgery, up to 30% of the patients are not satisfied after the operation. The aim of this study is to assess pain development within the first 4 weeks after TKA in order to gain a better understanding and detect possible influencing factors. Methods: A total of 103 patients were included in this prospective cohort study. Postoperative pain was indicated using a numeric rating scale (NRS). Furthermore, demographic data and perioperative parameters were correlated with the reported postoperative pain. Results: The evaluation of postoperative pain scores showed a constant decrease in the first postoperative week (mean NRS score of 5.8 on day 1 to a mean NRS score of 4.6 on day 8). On day 9, the pain increased again. Thereafter, a continuous decrease in pain intensity from day 10 on was noted (continuous to a mean NRS score of 3.0 on day 29). A significant association was found between postoperative pain intensity and gender, body mass index (BMI), and preoperative leg axis. Conclusions: The increasing pain score after the first postoperative week is most likely due to more intensive mobilization and physiotherapy in the rehabilitation department. Patients that were female, had a low BMI, and a preoperative valgus leg axis showed a significantly higher postoperative pain scores. Pain management should consider these results in the future to improve patient satisfaction in the postoperative course after TKA.

Etiology of Total Knee Arthroplasty Revisions: A Two-Decade Institutional Perspective

“…These main factors were also identified in our patient lot, either alone or combined; however, the analysis of the clinical parameters and risk factors was outside the scope of this paper. Nevertheless, while significant progress in rTKA indications, surgical planning and approach, robotic-assisted surgical options, management, and follow-up of patients has been recorded throughout the last 20 years, the definitive role and contribution of these improvements to primary TKA failure remain to be established [69][70][71][72][73][74][75][76][77].…”

The effect of hamstring donor-site block for functional outcomes and rehabilitation after anterior cruciate ligament reconstruction

“…Considering that gender is one of the confounders of pain ( 28 ), the baseline characteristics of the subjects were analyzed. The slight baseline difference between the two groups probably did not bias our results.…”

Assessment of various kinesiotherapy treatment approaches in reducing postoperative pain in patients with knee joint arthroplasty

“…Glavna indikacija za totalnu artroplastiku zgloba kolena je osteoartritis kolena jer dovodi do bola i ograničene pokretljivosti, a potom i do invaliditeta (1). Osteoartritis (gonartroza) je degenerativni proces koji se razvija u kolenu kao rezultat nesrazmere između opterećenja i podnošenja opterećenja od strane zglobne hrskavice kolena.…”

“…Osteoartritis (gonartroza) je degenerativni proces koji se razvija u kolenu kao rezultat nesrazmere između opterećenja i podnošenja opterećenja od strane zglobne hrskavice kolena. Najčešći faktori koji doprinose njegovom nastanku su starenje, gojaznost, nedostatak fizičke aktivnosti, ulazak žene u menopauzu, nasleđe, povrede zgloba kolena, zanimanja koja dodatno opterećuju zglobove kolena i drugo (1)(2)(3).…”

“…Kod većine pacijenata totalna artroplastika zgloba kolena otklanja bol, poboljšava pokretljivost, a samim tim doprinosi poboljšanju kvaliteta života (1). Ishod totalne artroplastike zgloba kolena zavisi od dobro postavljenih indikacija za operaciju, dobro obavljene operacije, kao i od pravovremenog i adekvatnog rehabilitacionog tretmana.…”