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

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.