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J Knee Surg 2016; 29(02): 169-178
DOI: 10.1055/s-0035-1549027
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

New and Common Perioperative Pain Management Techniques in Total Knee Arthroplasty

Randa K. Elmallah
1   Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Jeffrey J. Cherian
1   Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Todd P. Pierce
1   Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Julio J. Jauregui
1   Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Steven F. Harwin
2   Department of Orthopaedic Surgery, Mount Sinai Beth Israel Medical Center, New York, New York
,
Michael A. Mont
1   Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

20 January 2015

25 January 2015

Publication Date:
18 April 2015 (online)

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Abstract

Optimal pain control in patients undergoing total knee arthroplasty (TKA) is imperative for good rehabilitation and functional outcomes. However, despite technological advancements, surgeons continue to struggle with adequate pain management in their patients. Current modalities in use, such as patient-controlled analgesia, opioids, and epidural anesthetics, provide good pain relief but can be associated with side effects and serious complications. As a result, newer pain control modalities have been used to try to reduce the use of opioids while providing adequate pain relief. Currently, there are no clear guidelines or evidence for an optimum postoperative TKA analgesic regimen. Our aim was to evaluate the recent literature and provide a summary of the newer perioperative analgesic modalities. Evidence suggests that analgesics, such as newer oral medications, peripheral nerve blocks, and periarticular injections, may improve pain management, rehabilitation, and patient satisfaction, as well as reduce opioid consumption. The literature has also highlighted that a multimodal approach to pain management may provide the best results. However, determining which modalities provide superior pain control is still being extensively studied, and further research is needed.

Keywords

knee - pain management - total knee arthroplasty - blocks - injections
 

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