Arthritis of the knee affects approximately half of all Americans over the age of 60. When non-surgical treatments (like injections, weight loss, physical therapy, and non-narcotic medications) aren't helpful in treating the painful symptoms associated, total knee replacement (TKR) is often a good option.
According to a recent review in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), a team-based care approach (including the patient, family members, orthopaedic surgeon, and other medical practitioners) on TKR, along with newer pain management practices, lead to a better outcome.
Managing the post-surgical pain is arguably the key to postoperative mobility, and reducing medication side effects, thereby increasing patient satisfaction.
Typical pain management following surgery includes a computerized pump called the patient-controlled analgesia (PCA), with or without an epidural, which can cause nausea, vomiting, urinary retention, low blood pressure, constipation and itching.
Newer methods for pain control, known as multimodal protocols, are more effective at managing pain and limiting side effects. This approach includes:
- a combination of pain management medications (oral medications and nerve blocks) taken before and after surgery
- regional anesthesia with pre-operative nerve blocks performed by an anesthesiologist
- intra-operative pain injections performed by the orthopaedic surgeon directly into the knee
Multimodal protocols have proven to:
- reduce the amount of narcotic pain medication needed for postoperative pain
- help patients be better prepared for early postoperative physical therapy
And never underestimate the importance of a strong support system, such as friends and family, in helping a patient to achieve a speedy and successful recovery.
(Courtesy of AAOS-American Academy of Orthopaedic Surgeons)
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