Comprehensive Analysis Of Pain After Total Knee Arthroplasty

Total knee arthroplasty(TKA)has become one of the most common operations in joint surgery.Because it can quickly relieve the knee disease and reconstruct the function,it is accepted by most patients,but the postoperative pain rate has been high,and the quality of life of patients has been negatively affected.Research shows that more than a quarter of patients suffer from knee pain 2 years after TKA.The long-term pain after surgery interferes with patients’ daily life,resulting in patients having to repeatedly seek medical treatment,causing serious physical and mental trauma to patients,and even requiring secondary surgery to solve the residual pain problem of the first operation.At the same time,it causes unnecessary economic loss and waste of medical resources.Clinically,the causes of postoperative pain after TKA are complex and difficult to determine.There is no definite diagnostic and treatment strategies.Therefore,how to determine the causes of pain and reduce the incidence of postoperative pain has become an urgent problem to be solved.Objective:To investigate and analyze the causes of pain after primary TKA.Methods:120 patients who received primary total knee arthroplasty in the Second Affiliated Hospital of Bengbu Medical College from January 2014 to January 2020 were selected and followed up for at least one year.The VAS scores of 2 days,7 days,1 month,3 months,6 months and 1 year after operation were recorded.The mean score ≥ 3 was defined as pain group(23 cases)and < 3 as non pain group(97 cases).The data of gender,age,body mass index(BMI),postoperative infection of knee joint,postoperative instability of knee joint,postoperative stiffness of knee joint,postoperative poor patellar trajectory,postoperative joint line up were collected and analyzed by univariate and multivariate analysis.The measurement data were expressed by(` X±S),and the count data were expressed by(n,%),P < 0.05 is statistically significant.Results:Univariate analysis showed that there were significant differences between the pain group and the non pain group in postoperative knee infection,postoperative joint instability,postoperative knee stiffness,postoperative poor patellar trajectory and postoperative joint line upward movement(P < 0.05).Logistic multivariate analysis showed that postoperative knee infection(OR=0.021,95%CI 0.002 ～ 0.226,P=0.001),postoperative joint instability(OR=0.078,95%CI 0.013 ～ 0.472,P=0.005),postoperative knee stiffness(OR=0.076,95%CI 0.010 ～ 0.582,P=0.013),postoperative poor patella movement trajectory(OR=0.057,95%CI 0.010 ～0.318,P=0.001)and postoperative joint line movement upward(OR=0.087,95%CI0.010-0.735,P=0.025)were independent risk factors for pain after TKA.Conclusion : Postoperative knee infection,postoperative joint instability,postoperative knee stiffness,postoperative poor patellar trajectory and postoperative joint line upward movement are the causes of TKA postoperative pain.