Abstract
Background: Acute postoperative pain control after Total Knee Arthroplasty (TKA) is important given that poorly controlled, persistent pain can delay rehabilitation. The purpose of this study was to compare pain intensity during the early postoperative period (following the first and second surgeries) in patients who underwent bilateral, scheduled, staged TKAs. Materials and Methods: We enrolled 32 patients (64 knees) in this study and evaluated the number of requests for analgesic agents during the first 3 days after TKA, time to walking, and the Wong–Baker FACES pain assessment score (WBS). Results: Comparing the postoperative period following the first and second TKA, there were no significant differences in WBS 24, 48, and 72 h postoperatively. The frequency of requests, and the total number of requests for analgesics did not differ when comparing the first and second TKA, at any time point. The total number of analgesic requests exhibited a moderately strong, positive correlation between the first and second TKA (p < 0.001, r = 0.623). Patients’ WBS scores and requests for analgesics showed a moderately strong, positive correlation, but only at 24 h following the second TKA (p = 0.002, r = 0.567). After both TKAs, patients required a median of 1 day to resume walking. Conclusion: Patients undergoing staged bilateral TKA experienced equivalent early postoperative pain when comparing their experience following their first and second TKAs. Therefore, regarding pain control following the second TKA, we recommend considering the analgesic administration schedule and requirements of the first TKA.
Highlights
The debate over the superiority of simultaneous versus staged Total Knee Arthroplasty (TKA) for patients with bilateral knee Osteoarthritis (OA) remains controversial regarding perioperative complications and economic factors [1 - 7]
We objectively assessed pain using the number of analgesic agent requests issued by each patient during the first 3 days after surgery and the time needed to resume walking because we considered that more severe pain delays the time to resume walking These assessments can be used with conventional qualitative scales such as the WongBaker FACES pain assessment scale (WBS) (0; No pain, 1; hurts a little bit, 2; hurts a little more, 3; hurts even more, 4; hurts a whole lot, 5; hurts the worst) [13]
There was no significant difference in the frequency of analgesic requests over the first 3 postoperative days following TKA
Summary
The debate over the superiority of simultaneous versus staged Total Knee Arthroplasty (TKA) for patients with bilateral knee Osteoarthritis (OA) remains controversial regarding perioperative complications and economic factors [1 - 7]. Ritter et al (1997) [5] reported that neither simultaneous nor staged bilateral TKA was clinically superior, and the deci-. Regardless of the chosen procedure, pain control is important during the early postoperative period. Several studies [10 - 12] have reported that pain control differed between the first and second TKA. Acute postoperative pain control after Total Knee Arthroplasty (TKA) is important given that poorly controlled, persistent pain can delay rehabilitation. The purpose of this study was to compare pain intensity during the early postoperative period (following the first and second surgeries) in patients who underwent bilateral, scheduled, staged TKAs
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