Overview of Total Knee Arthroplasty and Modern Pain Control Strategies

Curr Pain Headache Rep. 2016 Nov;20(11):59. doi: 10.1007/s11916-016-0592-6.

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.

Keywords: Adductor canal block; Cryoneurolysis; Femoral nerve block; Local infiltrative analgesia; Multimodal pain management; Pain management; Periarticular injection; Total knee arthroplasty.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use*
  • Arthroplasty, Replacement, Knee*
  • Humans
  • Knee / surgery*
  • Nerve Block / methods
  • Pain Management* / methods
  • Pain, Postoperative / drug therapy*

Substances

  • Analgesics