The Journal of Bone and Joint Surgery; April 15, 2020; 102 (8): 719

Analgesia in Total Knee Arthroplasty

Summers Spencer, MD; Mohile Neil, MD; Mcnamara Colin, MD; Osman Brian, MD; Gebhard Ralf, MD; Hernandez Victor Hugo, MD, MS

Knee

Implementation of multimodal pain management regimens after total knee arthroplasty has increased patient satisfaction, decreased pain scores, and facilitated faster recovery.
A variety of oral and intravenous analgesics, including nonsteroidal anti-inflammatory drugs, gabapentinoids, acetaminophen, and opioids, can be employed preoperatively and postoperatively.
Neuraxial anesthesia, peripheral nerve blocks, and periarticular injections are effective pain modulators that should be implemented in concert with the anesthesia teams.
There is no consensus on the optimal multimodal pain regimen, and substantial variability exists between institutions and providers.
The goals of minimizing pain and improving functional recovery in the postoperative period must be considered in light of evidence-based practice as well as the risk profile of the proposed analgesic treatment.