Complex regional pain syndrome complicating total knee arthroplasty.

Area of Science:

• Orthopedic surgery
• Pain management
• Rehabilitation medicine

Background:

• Complex regional pain syndrome-type 1 (CRPS-1) can complicate total knee arthroplasty (TKA).
• Understanding the long-term outcomes of CRPS-1 post-TKA is crucial for patient management.

Purpose of the Study:

• To compare long-term outcomes of TKA patients with CRPS-1 to those with uncomplicated TKA and preoperative osteoarthritis.
• To evaluate functional recovery and pain scores in CRPS-1 patients following TKA.

Main Methods:

• Retrospective review of 1280 TKA patients; 8 diagnosed with CRPS-1 post-operatively.
• Exclusion of patients with inflammatory arthritis, component issues, or infection.
• Comparison of CRPS-1 patients with age- and sex-matched controls (uncomplicated TKA and pre-operative osteoarthritis knees).
• Assessment of range of motion, WOMOIAI, SF-36, and Knee Society scores over a mean 54-month follow-up.

Main Results:

• CRPS-1 patients achieved similar SF-36, WOMOIAI, and Knee Society scores compared to uncomplicated TKA patients after treatment.
• CRPS-1 patients showed significant improvement compared to their preoperative osteoarthritic state.
• The incidence of CRPS-1 following TKA was 0.7%.

Conclusions:

• Early intervention and management of CRPS-1 after TKA result in comparable long-term functional outcomes to uncomplicated TKA.
• CRPS-1 post-TKA, when appropriately treated, does not necessarily lead to a poorer long-term prognosis than standard TKA recovery.