Knee arthroplasty replaces diseased or damaged weight-bearing surfaces of the knee joint in order to relieve pain or cope with disability. Both, partial and total replacements are surgical approaches associated with substantial postoperative pain and intense physical rehabilitation to reestablish the knee motion. Total knee replacement is currently one of the most common orthopaedic procedures in the US and its worldwide frequency will probably keep growing as the population continues ageing. TKA is often associated with a high postoperative pain which needs to be kept under control to allow patients to go through the physical therapy essential for a good outcome. The recovery period is usually 6-weeks long and involves the use of mobility aids (e.g. walking frames, canes, crutches).
To better explain all procedures available for pain control, this Interactive Expert Exchange session will address the different causes of pain before focusing on pre and peri-operative considerations, and end up by listing diverse successful treatment options which facilitate the decision-making. The latest data regarding current pain handling (established and new) will be presented by a multinational panel of experts, which will reveal the best tips and tricks to ensure the best outcome for each patient.
Thursday 6 June 2019 | 10:00 to 12:15
Pain Management in TKA
Introduction & Conclusions
Emmanuel Thienpont (Belgium)
Presentations & Questions
What Types of Pain and Why Do Patients Experience Pain In TKA? | Nikolai Kornilov (Russia)
Per- And Perioperative Techniques to Better Control Postoperative Pain | Henrik Husted (Denmark)
My Enhanced Pain Control Protocol Ensures A Painless Procedure | Andrea Baldini (Italy)
Chronic Pain After TKA Despite Everything | Patricia Lavand’homme (Belgium)
Potential Reasons for Residual Pain After TKA | David Stuart Barrett (United Kingdom)
Clinical Cases - Discussion
Provocateurs: Andreas Halder (Germany) & Paolo Adravanti (Italy)
What would you do? – Scenario of Painful TKA
Mrs. Jones, a 56-year-old patient, consults because of unbearable knee pain after undergoing primary TKA at St. Elsewhere. She has been unlucky with her knee as indeed, after a minor accident at work, Dr. X performed an arthroscopy for a meniscal tear, but Mrs. Jones could not achieve the promised result. Six months later, she consulted Dr. Y, who explained she actually needed a lateral release of the patella. After this second surgery, Mrs. Jones developed a significant hematoma and stiff knee that needed mobilization under anesthesia (MUA). Thanks to vigorous physiotherapy and her strong determination, the patient could recover joint mobility after 1 year. However, she could not go back to work and the initially prescribed morphine did not help her any longer. She needed an alternative solution and went to see Dr. Z, who is well-known as a physician who is able to solve desperate cases. Within the first minutes of consultation, Dr. Z diagnosed the need for a joint replacement and performed the surgery the next day. After surgery he explained the wear he saw in her knee joint was significant, which made the case difficult to handle. Mrs. Jones developed another hematoma and needed another MUA and an arthroscopic arthrolysis performed 6 weeks apart. After an altercation with Dr. Z, who blamed the patient’s clinical history for the bad result, Mrs. Jones arrives at your office for medical advice and help...
Speakers of this Interactive Expert Exchange panel will discuss in-depth the risk factors for acute and chronic pain after knee arthroplasty and how to select the right type of arthroplasty for each patient. Moreover, the program of the session will highlight the decisive factors to determine what type of pain Mrs. Jones is experiencing and if anesthetic techniques should be adapted in case of revision surgery. Debate will occur around the many aspects to consider to define which postoperative pain control procedure needs to be used for this patient and what the potential reasons are for failure in this specific case presented. Finally, together with the audience, an appropriate strategy will be set to make sure Mrs. Jones receives a successful treatment and the best advice on how to deal with her knee pain. “Should we schedule her for revision surgery?” will be the last question to increase the interactivity between participants and reveal how this in-depth analysis can transpose key considerations to your daily practice.
The format of this exchange, including lectures, open debates and case presentations, will lead to a deep evaluation of all considerations for the surgeon to improve the general outcome of patients undergoing TKA. The highly experienced surgeons in the specialty of knee arthroplasty will discuss pros and cons of each pain control approach to help the attendees with decision-making.
As of this year, any fully registered EFORT Congress participant can attend the Interactive Expert Exchange sessions without any extra fee to be paid. All details to sign-up for the Lisbon meeting will be available on our registration platform as of January 2019.
Join the session and challenge the experts!