Treatment of pain in total knee arthroplasty favoring post-op physical activity

Total knee arthroplasty (TKA) is a successful procedure which has been performed with progressively increasing frequency to improve the functional outcome of arthritic patients. The initial period after surgery may be painful and slow postoperative rehabilitation which can compromise the long-term outcome of the arthroplasty. In an effort to provide more effective pain management, a multimodal approach to the treatment of postoperative pain has been introduced recently with the aim of reducing opioid consumptions, and its associated side effects, to permit improved range of motion and ambulatory ability. The combination of different intraoperative and postoperative analgesic techniques, associated with drug administration, seems to improve the satisfaction of the patient and of the surgeon. Exercise in older patients is associated with improvement in cardiovascular fitness and reduction in the risk of adverse effects of immobilization. Younger patients can also to return to sports activity after total knee arthroplasty. Exercise, if not excessive, may help to prevent the development of pain and maintain favorable durability of the arthroplasty.