Comparison of early postoperative pain after first vs second total knee arthroplasty

News Release: 18-May-2020

This article by Dr. Yoshinori Ishii et al. is published in The Open Orthopaedics Journal, Volume 14, 2020

Acute postoperative pain control after Total Knee Arthroplasty (TKA) is important as the poorly controlled, persistent pain can cause delay in rehabilitation. The researchers define the purpose of this study to be the comparison of pain intensity during the early postoperative period (following the first and second surgeries) in patients who underwent bilateral, scheduled, staged TKAs.

The researchers enrolled 32 patients (64 knees) in this study and evaluated the number of requests for analgesic agents during the first 3 days after TKA, time to walking, and the Wong-Baker FACES pain assessment score (WBS).

Comparing the postoperative period post the first and second TKA, there were no significant differences in WBS 24, 48, and 72 hours postoperatively. The frequency of requests, and the total number of requests for analgesics did not differ when comparing the first and second TKA, at any interval. The total number of analgesic requests exhibited a moderately strong, positive correlation between the first and second TKA (p < 0.001, r = 0.623). Patients' WBS scores and requests for analgesics showed a moderately strong, positive correlation, but only at 24 hours following the second TKA (p = 0.002, r = 0.567). After both TKAs, patients required a median of 1 day to resume walking.

Patients undergoing staged bilateral TKA experienced equivalent early postoperative pain when comparing their experience following their first and second TKAs. Therefore, regarding pain control following the second TKA, we recommend considering the analgesic administration schedule and requirements of the first TKA.

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