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Chronic pain after total knee arthroplasty

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Wylde, Vikki, Beswick, Andrew, Bruce, J. (Julie), Blom, Ashley, Howells, Nicholas and Gooberman-Hill, Rachael (2018) Chronic pain after total knee arthroplasty. EFORT Open Reviews, 3 (8). pp. 461-470. doi:10.1302/2058-5241.3.180004 ISSN 2058-5241.

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Official URL: http://dx.doi.org/10.1302/2058-5241.3.180004

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Abstract

Despite a good outcome for many patients, approximately 20% of patients experience chronic pain after total knee arthroplasty (TKA).

Chronic pain after TKA can affect all dimensions of health-related quality of life, and is associated with functional limitations, pain-related distress, depression, poorer general health and social isolation.

In both clinical and research settings, the approach to assessing chronic pain after TKA needs to be in-depth and multidimensional to understand the characteristics and impact of this pain. Assessment of this pain has been inadequate in the past, but there are encouraging trends for increased use of validated patient-reported outcome measures.

Risk factors for chronic pain after TKA can be considered as those present before surgery, intraoperatively or in the acute postoperative period. Knowledge of risk factors is important to guide the development of interventions and to help to target care. Evaluations of preoperative interventions which optimize pain management and general health around the time of surgery are needed.

The causes of chronic pain after TKA are not yet fully understood, although research interest is growing and it is evident that this pain has a multifactorial aetiology, with a wide range of possible biological, surgical and psychosocial factors that can influence pain outcomes.

Treatment of chronic pain after TKA is challenging, and evaluation of combined treatments and individually targeted treatments matched to patient characteristics is advocated. To ensure that optimal care is provided to patients, the clinical- and cost-effectiveness of multidisciplinary and individualized interventions should be evaluated.

Item Type: Journal Article
Subjects: R Medicine > RB Pathology
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Total knee replacement, Chronic pain -- Epidemiology, Chronic pain -- Etiology, Chronic pain -- Treatment, Chronic pain -- Risk factors, Epidemiology
Journal or Publication Title: EFORT Open Reviews
Publisher: British Editorial Society of Bone & Joint Surgery
ISSN: 2058-5241
Official Date: 16 August 2018
Dates:
DateEvent
16 August 2018Published
5 May 2018Accepted
Volume: 3
Number: 8
Page Range: pp. 461-470
DOI: 10.1302/2058-5241.3.180004
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 24 September 2018
Date of first compliant Open Access: 24 September 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RP-PG-0613-20001[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
UNSPECIFIEDUniversity Hospitals Bristol NHS Foundation Trusthttp://dx.doi.org/10.13039/100012141
UNSPECIFIEDUniversity of Bristolhttp://dx.doi.org/10.13039/501100000883

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