Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 11/2016

01-11-2016 | Other Pain (N Vadivelu and A Kaye, Section Editors)

Overview of Total Knee Arthroplasty and Modern Pain Control Strategies

Authors: Lacey Giambelluca Lavie, M. Patricia Fox, Vinod Dasa

Published in: Current Pain and Headache Reports | Issue 11/2016

Login to get access

Abstract

Perioperative pain management of total knee arthroplasty (TKA) remains a challenge for physicians and anesthesiologists. Reducing postoperative pain is an essential component of patient satisfaction, functional outcomes, and hospital length of stay. Multimodal pain management regimens have been demonstrated to be superior to monotherapy in achieving adequate pain control, as well as an effective method of limiting side effects of analgesics. In the present investigation, we present literature published over the last year relating to new advancements in perioperative pain management for TKA. While it is widely accepted that methods including peripheral nerve blocks and local anesthetic injections are essential to pain protocols, there is still conflicting evidence over what modalities provide superior relief. The incorporation of cryoneurolysis preoperatively is a new modality which has been incorporated and has been shown to improve pain control in patients undergoing TKA.
Literature
1.
Lamplot JD, Wagner ER, Manning DW. Multimodal pain management in total knee arthroplasty. J Arthroplast. 2014;29(2):329–34.CrossRef
2.
Dong CC, Dong SL, He FC. Comparison of adductor canal block and femoral nerve block for postoperative pain in total knee arthroplasty: a systematic review and meta-analysis. Medicine (Baltimore). 2016;95(12):e2983.CrossRef
3.
Pulos N, Sheth N. Perioperative pain management following total joint arthroplasty. Ann Orthop Rheumatol. 2014;2(3):1029.
4.
Chughtai M, Jauregui JJ, Mistry JB, Elmallah RK, Diedrich AM, Bonutti PM, et al. What influences how patients rate their hospital after total knee arthroplasty? Surg Technol Int. 2016;28:261–5.PubMed
5.•
Apfelbaum JL, Ashburn MA, Connis RT, Gan TJ, Nickinovich DG, Caplan RA, Carr DB, Ginsberg B, Green CR, Lema MJ, Rice LJ. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012;116(2):248–73. The importance of multimodal pain analgesia cannot be emphasized enough to improve short-term outcomes following TKA.
6.
Gabriel RA, Kaye AD, Nagrebetsky A, Jones MR, Dutton RP, Urman RD. Utilization of femoral nerve blocks for total knee arthroplasty. J Arthroplasty. 2016;31(8):1680–5.CrossRefPubMed
7.
Dalury DF. A state-of-the-art pain protocol for total knee replacement. Arthroplasty Today. 2016;2(1):23–5.CrossRef
8.
Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop. 2008;79(2):174–83.CrossRefPubMed
9.
Tsukada S, Wakui M, Hoshino A. The impact of including corticosteroid in a periarticular injection for pain control after total knee arthroplasty: a double-blind randomised controlled trial. Bone Joint J. 2016;98-B(2):194–200.CrossRefPubMedPubMedCentral
10.
Vendittoli PA, Makinen P, Drolet P, Lavigne M, Fallaha M, Guertin MC, et al. A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study. J Bone Joint Surg Am. 2006;88(2):282–9.CrossRefPubMed
11.
Barrington JW, Emerson RH, Lovald ST, Lombardi AV, Berend KR. No difference in early analgesia between liposomal bupivacaine injection and intrathecal morphine after TKA. Clin Orthop Relat Res. 2016. doi:10.​1007/​S11999-D16-4931-z.
12.
Ludwigson JL, Tillmans SD, Galgon RE, Chambers TA, Heiner JP, Schroeder KM. A comparison of single shot adductor canal block versus femoral nerve catheter for total knee arthroplasty. J Arthroplasty. 2015;30(9 Suppl):68–71.CrossRefPubMed
13.
Kurosaka K, Tsukada S, Seino D, Morooka T, Nakayama H, Yoshiya S. Local infiltration analgesia versus continuous femoral nerve block in pain relief after total knee arthroplasty: a randomized controlled trial. J Arthroplasty. 2016;31(4):913–7.CrossRefPubMed
14.
Auyong DB, Allen CJ, Pahang JA, Clabeaux JJ, MacDonald KM, Hanson NA. Reduced length of hospitalization in primary total knee arthroplasty patients using an updated enhanced recovery after orthopedic surgery (ERAS) pathway. J Arthroplasty. 2015;30(10):1705–9.CrossRefPubMed
15.••
Dasa V, Lensing G, Parsons M, Harris J, Volaufova J, Bliss R. Percutaneous freezing of sensory nerves prior to total knee arthroplasty. Knee. 2016;23(3):523–8. The first study of its kind addressing long-term perioperative pain control using novel technology.CrossRefPubMed
16.
Dasa V, Lensing G, Parsons M, et al. An ancient treatment for present-day surgery: percutaneously freezing sensory nerves for treatment of postsurgical knee pain. Tech Reg Anesth Pain Manag. 2014;18(4):145–9.CrossRef
Metadata
Title
Overview of Total Knee Arthroplasty and Modern Pain Control Strategies
Authors
Lacey Giambelluca Lavie
M. Patricia Fox
Vinod Dasa
Publication date
01-11-2016
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 11/2016
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-016-0592-6