Department of Anesthesiology and Pain Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada.
Department of Anesthesiology & Perioperative Medicine.
Pain Med. 2020 May 1;21(5):1049-1060. doi: 10.1093/pm/pnz355.
The relationship between preexisting osteoarthritic pain and subsequent post-total knee arthroplasty (TKA) pain is not well defined. This knowledge gap makes diagnosis of post-TKA pain and development of management plans difficult and may impair future investigations on personalized care. Therefore, a set of diagnostic criteria for identification of acute post-TKA pain would inform standardized management and facilitate future research.
The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration (FDA), the American Pain Society (APS), and the American Academy of Pain Medicine (AAPM) formed the ACTTION-APS-AAPM Pain Taxonomy (AAAPT) initiative to address this goal. A multidisciplinary work group of pain experts was invited to conceive diagnostic criteria and dimensions of acute post-TKA pain.
The working group used contemporary literature combined with expert opinion to generate a five-dimensional taxonomical structure based upon the AAAPT framework (i.e., core diagnostic criteria, common features, modulating factors, impact/functional consequences, and putative mechanisms) that characterizes acute post-TKA pain.
The diagnostic criteria created are proposed to define the nature of acute pain observed in patients following TKA.
预先存在的骨关节炎疼痛与全膝关节置换术后(TKA)后疼痛之间的关系尚未明确。这一知识空白使得 TKA 后疼痛的诊断和管理计划的制定变得困难,并可能影响未来关于个性化护理的研究。因此,一套用于识别急性 TKA 后疼痛的诊断标准将有助于规范管理,并为未来的研究提供便利。
镇痛、麻醉和成瘾临床试验转化、创新、机遇和网络(ACTION)与美国食品和药物管理局(FDA)、美国疼痛协会(APS)和美国疼痛医学学院(AAPM)的公私合作伙伴关系,成立了 ACTION-APS-AAPM 疼痛分类学(AAAPT)倡议,以实现这一目标。一个由疼痛专家组成的多学科工作组被邀请提出急性 TKA 后疼痛的诊断标准和维度。
工作组结合当代文献和专家意见,基于 AAAPT 框架(即核心诊断标准、常见特征、调节因素、影响/功能后果和假定机制)生成了一个五维分类结构,用于描述急性 TKA 后疼痛。
提出的诊断标准旨在定义 TKA 后患者观察到的急性疼痛的性质。