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Pain after knee arthroplasty: An unresolved issue

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Grosu, Irina [UCL] Lavand'homme, Patricia [UCL] Thienpont, Emmanuel [UCL]

Purpose: Despite the recent advances in the understanding of pain mechanisms and the introduction of new drugs and new techniques in the postoperative management, pain after total knee arthroplasty (TKA) is still an unresolved issue. It affects the quality of life and rehabilitation of an important percentage of patients undergoing TKA. The aim of this narrative review was to give an overview on pain mechanisms and multimodal pain management. Methods: A review of all peer-reviewed articles on pain after knee arthroplasty was performed by two reviewers. Recent articles on incisional pain mechanisms were included because of their importance in the understanding of postsurgical pain. Search was performed in Pubmed, Cochrane and Google Scholar data bases. Results: Postsurgical pain mechanisms are based on both local and systemic inflammatory reactions. Peri-operative pain management starts with the anaesthetic technique and resides on a multimodal analgesia regimen. New concepts, drugs and techniques have shown their efficacy in reducing the severity of acute postoperative pain and the risk of developing chronic pain after TKA. Conclusion: This narrative review offers a clear overview of pain mechanism after knee arthroplasty and an understanding on how multimodal pain management can reduce the intensity and duration of pain after knee arthroplasty. Level of evidence: IV. © 2013 Springer-Verlag Berlin Heidelberg.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès restreint
Publication date 2014
Language Anglais
Journal information "Knee Surgery, Sports Traumatology, Arthroscopy" - Vol. 22, no. 8, p. 1744-1758 (2014)
Peer reviewed yes
Publisher Springer ((Germany) Heidelberg)
issn 0942-2056
e-issn 1433-7347
Publication status Publié
Affiliations UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery
UCL - (SLuc) Service d'anesthésiologie
UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur
UCL - SSS/IONS - Institute of NeuroScience
UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire
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Bibliographic reference Grosu, Irina ; Lavand'homme, Patricia ; Thienpont, Emmanuel. Pain after knee arthroplasty: An unresolved issue. In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 22, no. 8, p. 1744-1758 (2014)
Permanent URL http://hdl.handle.net/2078.1/164242