Sauter Axel, Breivik Harald
J Pain Palliat Care Pharmacother. 2014 Jun;28(2):164-5; discussion 165-6. doi: 10.3109/15360288.2014.911797. Epub 2014 May 7.
Acute pain during and immediately after total knee arthroplasty (TKA) can be well controlled by spinal anesthesia, local infiltration analgesia, and peripheral nerve blocks; this enables early or fast-track rehabilitation. However, about half of patients have clinically significant pain in the following weeks. Active movements and rehabilitation of joint function, muscle strength, and ability to maintain balance and prevent falls all become more difficult when the joint is painful on movement. Intensive analgesic and antihyperalgesic treatment during the first few weeks after TKA surgery may reduce the risk of chronic pain after this operation, which is itself intended to remove the patient's chronic osteoarthritis pain. Spinal cord stimulation may be an effective option for patients with mainly neuropathic pain after TKA surgery.
全膝关节置换术（TKA）期间及术后即刻的急性疼痛可通过脊髓麻醉、局部浸润镇痛和外周神经阻滞得到良好控制；这有助于早期或快速康复。然而，约一半的患者在接下来的几周内会出现具有临床意义的疼痛。当关节在活动时疼痛时，主动活动以及关节功能、肌肉力量、维持平衡和预防跌倒能力的康复都会变得更加困难。TKA手术后最初几周内进行强化镇痛和抗痛觉过敏治疗可能会降低该手术后慢性疼痛的风险，而TKA手术本身旨在消除患者的慢性骨关节炎疼痛。脊髓刺激可能是TKA手术后主要患有神经性疼痛患者的一种有效选择。
