Total Knee Athroplasty Neuropathic Pain
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton
UNDER CONSTRUCTION 3.4.2024 Introduction[edit | edit source]
Knee Replacement (KR) procedures are regularly performed now. 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.
Sub Heading 2[edit | edit source]
Neuropathic pain rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have neuropathiclong term neuropathic pain.
Post-surgical pain with a neuropathic component likely to be greater than pure nociceptive pain, poorly 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.
There are UK NICE guidelines for the assessment and treatment of neuropathic pain. These include offering a choice of
amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment. Capsaicin cream or topical lidocaine can be considered
for people with localised neuropathic pain or neuroma
Sub Heading 3[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x