Abstract
Great strides have been made in perioperative pain management after total knee arthroplasty (TKA) leading to reduced length of hospital stay, cost reduction, improved patient satisfaction, and more rapid recovery without affecting the rates of readmission after surgery. To assure a happy patient, early recognition of patients at risk for persistent postoperative pain prior to surgery is key. Patients on chronic pain medication should be evaluated by pain management specialists with the intention of reducing overall narcotic requirement prior to TKA. Patients with high anxiety levels, pain catastrophizing, and Kinesphobia are at increased risk for increased pain and poor outcomes and should be referred for cognitive behavioral therapy and coping strategies. Finally, patients with hypersensitivity syndromes localised in the soft tissue around the knee should undergo desensitization protocols prior to TKA. Patient education on the risk of increased postoperative pain is crucial to manage expectations and optimise modifiable risk factors prior to TKA. To assure a happy patient indicated for TKA, a comprehensive pain management strategy divided into pre-, intra-, and post-operative periods should be employed.
