According to a new literature review in the February issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), a team-based care approach (consisting of the patient, family members, the orthopaedic surgeon and other medical practitioners) on total knee replacement (TKR) procedures, in conjunction with newer pain management strategies, is key to maximizing patient outcomes.
Arthritis of the knee impacts approximately 50 percent of Americans over the age of 60. "TKR is a highly successful procedure used to treat symptomatic knee arthritis that's not responsive to nonsurgical treatments like injections, weight loss, physical therapy and non-narcotic medications," says lead study author and orthopaedic surgeon Calin S. Moucha, MD, chief of adult reconstruction and joint replacement surgery at The Mount Sinai Hospital in New York City.
"Managing post-surgical pain is key to promoting early postoperative mobility, reducing medication side effects, and increasing patient satisfaction," says Dr. Moucha.
Traditional pain management for TKRs include a computerized pump called the patient-controlled analgesia (PCA) with or without an epidural which can lead to nausea, vomiting, urinary retention, low blood pressure, constipation and itching. Newer pain-control strategies--referred to as multimodal protocols--more effectively manage pain and limit side effects. These include:
Multimodal protocols are found to:
The study authors also note that:
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