Neurointerventional and Interventional Vascular Unit, Université Côte d'Azur (UCA), Hôpital Pasteur 2, CHU Nice, 30 Voie Romaine, Nice, France.
Department of Rheumatology, Université Côte d'Azur (UCA), Hôpital Pasteur 2, Nice, France.
Cardiovasc Intervent Radiol. 2020 May;43(5):787-790. doi: 10.1007/s00270-020-02449-x. Epub 2020 Mar 6.
Approximately 20% of patients have persistent unexplained pain after total knee arthroplasty (TKA). Currently available treatments are unsatisfactory. The present report describes four patients in whom transcatheter arterial embolization had a remarkable effect on pain after TKA. Abnormal neovessels were identified in all patients. For 48 h, one patient experienced remarkable postprocedural pain at the inner side of the knee that was subsided by level 1 analgesics and another patient development of a spontaneous skin ulceration resolving within 8 days. The mean Knee injury and Osteoarthritis Outcome Score pain subtotal had increased from 39 to 82 one month after treatment. Endovascular occlusion of neovascularization, decreasing chronic inflammation and the growth of unmyelinated sensory nerves may be treatment options for persistent unexplained pain following TKA.Level of Evidence IV, Case report.
约 20%的全膝关节置换术（TKA）后患者存在持续无法解释的疼痛。目前可用的治疗方法并不令人满意。本报告描述了 4 例 TKA 后经导管动脉栓塞治疗疼痛显著的患者。所有患者均发现异常新生血管。有 1 例患者在术后 48 小时内出现膝关节内侧显著的术后疼痛，用 1 级镇痛药缓解，另 1 例患者出现自发性皮肤溃疡，8 天内愈合。治疗后 1 个月，膝关节损伤和骨关节炎结果评分疼痛总分从 39 分增加到 82 分。血管内闭塞新生血管，减少慢性炎症和无髓感觉神经的生长，可能是 TKA 后持续无法解释的疼痛的治疗选择。证据等级 IV，病例报告。
