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Chronic pain after total knee arthroplasty

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, p...

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Autores principales: Wylde, Vikki, Beswick, Andrew, Bruce, Julie, Blom, Ashley, Howells, Nicholas, Gooberman-Hill, Rachael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134884/
https://www.ncbi.nlm.nih.gov/pubmed/30237904
http://dx.doi.org/10.1302/2058-5241.3.180004
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author Wylde, Vikki
Beswick, Andrew
Bruce, Julie
Blom, Ashley
Howells, Nicholas
Gooberman-Hill, Rachael
author_facet Wylde, Vikki
Beswick, Andrew
Bruce, Julie
Blom, Ashley
Howells, Nicholas
Gooberman-Hill, Rachael
author_sort Wylde, Vikki
collection PubMed
description 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. Cite this article: EFORT Open Rev 2018;3:461-470. DOI: 10.1302/2058-5241.3.180004
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spelling pubmed-61348842018-09-20 Chronic pain after total knee arthroplasty Wylde, Vikki Beswick, Andrew Bruce, Julie Blom, Ashley Howells, Nicholas Gooberman-Hill, Rachael EFORT Open Rev Knee 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. Cite this article: EFORT Open Rev 2018;3:461-470. DOI: 10.1302/2058-5241.3.180004 British Editorial Society of Bone and Joint Surgery 2018-08-16 /pmc/articles/PMC6134884/ /pubmed/30237904 http://dx.doi.org/10.1302/2058-5241.3.180004 Text en © 2018 The author(s) https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Knee
Wylde, Vikki
Beswick, Andrew
Bruce, Julie
Blom, Ashley
Howells, Nicholas
Gooberman-Hill, Rachael
Chronic pain after total knee arthroplasty
title Chronic pain after total knee arthroplasty
title_full Chronic pain after total knee arthroplasty
title_fullStr Chronic pain after total knee arthroplasty
title_full_unstemmed Chronic pain after total knee arthroplasty
title_short Chronic pain after total knee arthroplasty
title_sort chronic pain after total knee arthroplasty
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134884/
https://www.ncbi.nlm.nih.gov/pubmed/30237904
http://dx.doi.org/10.1302/2058-5241.3.180004
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