Multimodal pain management and arthrofibrosis

The Journal of Arthroplasty
Carlos LaverniaDavid Lee

Abstract

Pain control after arthroplasty has been a key concern for orthopedic surgeons. After total knee arthroplasty (TKA), a small group of patients developed a painful joint with suboptimal range of motion. Manipulation under anesthesia increases flexion and extension while decreasing pain in most cases. The objective of the present investigation is to asses the effect of a multimodal pain management protocol on arthrofibrosis in primary TKAs. A cohort of 1136 patients who underwent primary TKA was selected. Patients were divided into 2 groups: group A had 778 procedures performed using a traditional approach to pain control; group B included 358 procedures that received multimodal pain management. Group A had an incidence of manipulation of 4.75% (37/778). Of 357 patients, 8 required manipulation in group B, which is an incidence of 2.24%. We recommend that orthopedic surgeons consider using a multimodal pain management protocol for TKA.

References

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Citations

Nov 18, 2011·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Tilman PfitznerGeorg Matziolis
Feb 9, 2012·Orthopedics·Michele R D'ApuzzoRafael J Sierra
Jul 5, 2011·The Journal of Arthroplasty·William G HamiltonC Anderson Engh
Feb 6, 2013·Orthopedics·Javad Parvizi, Michael R Bloomfield
Dec 20, 2011·Annals of Physical and Rehabilitation Medicine·M DautyC Dubois
Apr 4, 2018·JBJS Reviews·Erik ZachwiejaNeil Sheth
Jul 19, 2019·The Journal of Bone and Joint Surgery. American Volume·Meagan E TibboMatthew P Abdel
Jun 25, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Hannah L PaishNicholas S Kalson
Nov 23, 2019·EFORT Open Reviews·E Carlos Rodríguez-Merchán

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