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Review
. 2021 Apr 17;25(6):42.
doi: 10.1007/s11916-021-00956-1.

Management of Refractory Pain After Total Joint Replacement

Max L Willinger  1 , Jamie Heimroth  1 , Nipun Sodhi  1 , Luke J Garbarino  1 , Peter A Gold  2 , Vijay Rasquinha  1 , Jonathan R Danoff  3 , Sreevathsa Boraiah  3
Affiliations
Review

Management of Refractory Pain After Total Joint Replacement

Max L Willinger et al. Curr Pain Headache Rep. .

Abstract

Purpose of review: Chronic pain after total joint replacement (TJA), specifically total knee replacement (TKA), is becoming more of a burden on patients, physicians, and the healthcare system as the number of joint replacements performed increases year after year. The management of this type of pain is critical, and therefore, understanding the various modalities physicians can use to help patients with refractory pain after TJA is essential.

Recent findings: The modalities by which chronic pain can be successfully managed include genicular nerve radioablation therapy (GN-RFA), neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and peripheral subcutaneous field stimulation (PSFS). Meta-analyses and case reports have demonstrated the effectiveness of these treatment options in improving pain and functional outcomes in patients with chronic pain after TKA. The purpose of this paper is to review and synthesize the current literature investigating the different ways that refractory pain is managed after TJA, with the goal being to provide treatment recommendations for providers treating these patients.

Keywords: Chronic pain; Genicular nerve radiofrequency ablation; Knee osteoarthritis; Postoperative analgesia; Refractory pain; Total joint arthroplasty.

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References

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