Total Knee Athroplasty Neuropathic Pain: Difference between revisions
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== '''UNDER CONSTRUCTION 3.4.2024 '''Introduction == | == '''UNDER CONSTRUCTION 3.4.2024 '''Introduction == | ||
Knee | Knee joint [[arthroplasty]] (KJA) procedures are regularly performed, however up to 1/5 of these replacements cause patients to have a degree of long-term pain or are not satisfied with their surgery. | ||
[[Neuropathic Pain|Neuropathic pain]] rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have long term neuropathic pain. | [[Neuropathic Pain|Neuropathic pain]] rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have long term neuropathic pain. | ||
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Various guidelines exist for the assessment and treatment of neuropathic pain. These include offering a choice of | Various guidelines exist for the assessment and treatment of neuropathic pain. These include offering a choice of | ||
* Amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment. | * Amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment. See [[Neuropathic Pain Medication|Neuropathic pain medications]]. | ||
* Capsaicin cream or topical lidocaine is an option for localised neuropathic pain or neuroma | * Capsaicin cream or topical lidocaine is an option for localised neuropathic pain or neuroma | ||
Revision as of 07:43, 4 April 2024
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton
UNDER CONSTRUCTION 3.4.2024 Introduction[edit | edit source]
Knee joint arthroplasty (KJA) procedures are regularly performed, however up to 1/5 of these replacements cause patients to have a degree of long-term pain or are not satisfied with their surgery.
Neuropathic pain rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have long term neuropathic pain.
- Post-surgical pain with a neuropathic component is likely to be greater than pure nociceptive pain, affecting QOL.
- Neuropathic pain may stem from sensitisation of peripheral nociceptors many sources eg inflamed synovium, damaged subchondral bone, surgery trauma.
- Patients with a pre existing neuropathic pain elsewhere have a greater potential for chronic nociceptor stimulation and central pain transmission.
Features[edit | edit source]
Neuropathic pain is distinguished by the following features: pain not relieved by rest and analgesia; diffuse and difficult to localise pain; pain that radiates towards or away from the knee; pain associated with feelings of pressure, numbness, sensitivity, burning, stinging, electric shocks or rigidity.
Assessing[edit | edit source]
Neuropathic pain can be assessed by various validated scoring systems, the most commonly used is the PainDETECT, a helpful assessment tool in this patient group.
Various guidelines exist for the assessment and treatment of neuropathic pain. These include offering a choice of
- Amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment. See Neuropathic pain medications.
- Capsaicin cream or topical lidocaine is an option for localised neuropathic pain or neuroma
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Resources[edit | edit source]
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