Literature review of the causes of pain following total knee replacement surgery: prosthesis inflammation and arthrofibrosis

Adverse knee pain occurs in 10-34% of all total knee replacements (TKR), and 20% of TKR patients experience more pain post-operatively than pre-operatively. Knee pain is amonc.)st the top five reasons for knee replacement revision in the United Kingdom. The number of TKRs predicted to continue increasing due to the ageing population. A narrative literature review was performed on the different causes of pain following TKR. A database search on Scopus, PuINIed, and Google S(Tholar was conducted to look for articles related to TKR, pain, and mm e, Articles were selected based on: relevance, publication date, quality of research and validation, Relevant sections were added to the mview One hundred and fourteen articles were identified and potential c a eS of TKR pain included: arthrofibross, aseptic loosening, avascular necrosis, ceptral sepsitization, component malpositioning, infection, instability, nerve damage, overstuffing, patellar maltracking, polyethylene wear, psychological f actors and unresti rfaced patella. III It 15 important to tailor our approach to address the individual cdUSeS ot pain. Certain controllable risk factors can be managed pre -operatively to minimize post-operative pain, Risk factors help to predict adverse pain outcomes and identify specific causes. There are multiple causes of pain following TKR, Some factors will require ftgther extensive studios, an d as pain is a commoply attributed reason, for TKR revision, its upderlying aetiologies should be explored. Understanding these factors helps to develop effective methods for diagnosis, prevention -rrid management of TKR pain, which help to improve patient outcomes,