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.

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