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. 2025 Dec;39(6):869-877.
doi: 10.1007/s00540-025-03529-3. Epub 2025 Jun 28.

Impact of a multidisciplinary pain management team on acute and chronic pain management after total knee arthroplasty

Tomoo Yuba  1 , Shunsuke Yamamoto  2 , Hironobu Uematsu  2   3 , Takeshi Yoshida  2
Affiliations

Impact of a multidisciplinary pain management team on acute and chronic pain management after total knee arthroplasty

Tomoo Yuba et al. J Anesth. 2025 Dec.

Abstract

Purpose: The impact of multidisciplinary team (MDT) interventions on chronic postsurgical pain remains unclear. This study evaluated the effects of MDT on acute and chronic pain outcomes in total knee arthroplasty (TKA) patients.

Methods: This retrospective cohort study included 324 patients who underwent unilateral TKA between April 2017 and March 2023. The patients were divided into pre-MDT (n = 147) and post-MDT (n = 177) groups. The MDT, comprising anesthesiologists, pain nurses, and pharmacists, conducted daily rounds from postoperative day (POD) 1 to 4. The acute (duration of nerve block, incidence of breakthrough pain [BTP]) and chronic outcomes at 3 months (movement-related numerical rating scale [NRS] scores, regular analgesic use) were compared. Statistical significance was set at p < 0.05.

Results: The preoperative demographics were comparable between groups. The MDT significantly prolonged nerve block duration (2.7 ± 1.0 vs. 3.0 ± 1.5 days, p = 0.027) and reduced BTP incidence (50.3 vs. 29.4%, p = 0.0001). At 3 months, movement-related NRS scores were lower in the post-MDT group (4.2 ± 3.5 vs. 2.1 ± 2.4, p = 0.025), while regular analgesic use showed no significant difference (21.8 vs. 16.9%, p = 0.31).

Conclusion: MDT intervention improved acute pain management by reducing BTP and ensuring optimal nerve block use. Additionally, MDT was associated with better chronic pain outcomes, reflected in lower movement-related NRS scores at 3 months. These findings highlight MDTs' role in improving acute pain management and reducing movement-related pain at 3 months after TKA.

Keywords: Acute pain management; Chronic postsurgical pain; Multidisciplinary pain management team; Total knee arthroplasty.

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Conflict of interest statement

Declarations. Conflict of interest: The authors report that there is no conflict of interest. Ethics approval: This study was approved by the Ethical Review Committee of Osaka University Hospital (approval no. 21489). This study was conducted in strict accordance with the principles of the Declaration of Helsinki (World Medical Association, 1964) and its subsequent revisions, which set internationally accepted ethical standards for research involving human subjects. Consent to participate: This study employed an opt-out method in accordance with the ethical guidelines. Written informed consent was not obtained from any participant. Instead, comprehensive information about the study's purpose, procedures, risks, and handling of personal information was made available to potential participants through posters displayed in areas frequented by the target population, and pamphlets placed or distributed at relevant locations.

Figures

Fig. 1
Fig. 1
Acute postoperative outcomes with and without multidisciplinary pain management team (MDT) intervention. This figure shows the acute postoperative outcomes. A duration of nerve block, B incidence of breakthrough pain (BTP), C rehabilitation start time, D length of hospital stay. The MDT group demonstrated a longer nerve block duration and reduced BTP
Fig. 2
Fig. 2
Chronic postoperative outcomes at 3 months with and without pain management team (MDT) intervention This figure presents the chronic postoperative outcomes at 3 months, including A regular analgesic use, B resting numerical rating scale (NRS) scores; and C movement-related NRS scores. Significant reductions in the movement-related NRS scores were observed in the MDT group
See this image and copyright information in PMC

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References

    1. Kurtz SM, Ong KL, Schmier J, Mowat F, Saleh K, Dybvik E, Karrholm J, Garellick G, Havelin LI, Furnes O, Malchau H, Lau E. Future clinical and economic impact of revision total hip and knee arthroplasty. J Bone Joint Surg Am. 2007;89(Suppl 3):144–51. 10.2106/JBJS.G.00587. - DOI - PubMed
    1. Kehlet H. Effect of postoperative pain treatment on outcome-current status and future strategies. Langenbecks Arch Surg. 2004;389(4):244–9. 10.1007/s00423-004-0460-4. - DOI - PubMed
    1. Wylde V, Hewlett S, Learmonth ID, Dieppe P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain. 2011;152(3):566–72. 10.1016/j.pain.2010.11.023. - DOI - PubMed
    1. Willingham MD, Vila MR, Ben Abdallah A, Avidan MS, Haroutounian S. Factors contributing to lingering pain after surgery: the role of patient expectations. Anesthesiology. 2021;134(6):915–24. 10.1097/ALN.0000000000003754. - DOI - PubMed
    1. Terkawi AS, Mavridis D, Sessler DI, Nunemaker MS, Doais KS, Terkawi RS, Terkawi YS, Petropoulou M, Nemergut EC. Pain management modalities after total knee arthroplasty: a network meta-analysis of 170 randomized controlled trials. Anesthesiology. 2017;126(5):923–37. 10.1097/ALN.0000000000001607. - DOI - PubMed

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