Toms A D, Mandalia V, Haigh R, Hopwood B
Exeter Knee Reconstruction Unit, Royal Devon & Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
J Bone Joint Surg Br. 2009 Feb;91(2):143-50. doi: 10.1302/0301-620X.91B2.20995.
The management of patients with a painful total knee replacement requires careful assessment and a stepwise approach in order to diagnose the underlying pathology accurately. The management should include a multidisciplinary approach to the patient's pain as well as addressing the underlying aetiology. Pain should be treated with appropriate analgesia, according to the analgesic ladder of the World Health Organisation. Special measures should be taken to identify and to treat any neuropathic pain. There are a number of intrinsic and extrinsic causes of a painful knee replacement which should be identified and treated early. Patients with unexplained pain and without any recognised pathology should be treated conservatively since they may improve over a period of time and rarely do so after a revision operation.
对于全膝关节置换术后疼痛患者的管理，需要进行仔细评估并采取逐步的方法，以便准确诊断潜在的病理状况。管理应包括针对患者疼痛的多学科方法以及解决潜在病因。应根据世界卫生组织的镇痛阶梯，使用适当的镇痛药物治疗疼痛。应采取特殊措施来识别和治疗任何神经性疼痛。全膝关节置换术后疼痛存在多种内在和外在原因，应尽早识别并治疗。对于原因不明且无任何公认病理状况的患者，应采取保守治疗，因为他们可能会在一段时间内有所改善，而翻修手术后很少能改善。
