人工膝関節置換術における遷延性術後痛

抄録

Total Knee Arthroplasty (TKA) is a highly successful procedure of treating severe arthritis of the knee. However, a significant proportion of the patients have chronic postsurgical pain after TKA. Although component malpositioning and insufficient soft tissue balancing are possible causes, chronic postsurgical pain is often observed after uncom­plicated TKA and unexplained by routine examinations. Risk factors for un­explained chronic postsurgical pain include female, young patients, preoperative pain severity, pain at other sites, central sensitization, pain catastrophizing, and depression. Some of these factors can be modified by surgical techniques and pain management. It is also reported that preoperative psychological interventions possibly improve mental health problems. It is imperative to identify the factors associated with poor outcome and development of chronic postsurgical pain after uncomplicated TKA. To date, there is no evidence that some intervention decreases the incidence of chronic postsurgical pain. Future studies are needed to establish preventive measures.