Management of Painful Knee Replacement - Dr S Khot

Description

The presentation begins with Dr. Sharmila Khodam introducing herself as a consultant in anesthesia and pain medicine at the University Hospital Wales, Cardiff, and a clinical researcher at Cardiff University. She discusses the topic of chronic pain following total knee replacement surgery, emphasizing the need to understand the multifaceted nature of pain, particularly its biopsychosocial aspects.



Dr. Khodam outlines the objectives of her talk: to define pain, explore the pathophysiology of chronic postsurgical pain, and identify risk factors for its development, as well as prevention and management strategies.



She elaborates on the complexity of pain, explaining how it is both a sensory and emotional experience, and how chronic pain can alter brain structures and processing. The talk covers the evolution of knee pain from acute to chronic, emphasizing biomedically driven changes that occur in the body, including neural and biochemical alterations.



Specific attention is given to the classification of pain types, such as nociceptive and neuropathic pain, and predictors of chronic pain following surgery. Dr. Khodam discusses various studies that identify risk factors, including psychological factors, preexisting pain conditions, and genetic predispositions.



Preventative measures to minimize chronic pain and the importance of tailored analgesic protocols are highlighted, including the effectiveness of multimodal analgesia and specific medications like gabapentin and pregabalin. Dr. Khodam also notes that while some studies have reported reduced morphine consumption due to these medications, further research is needed for more conclusive results.



The presentation wraps up by discussing innovative treatments such as nerve blocks and advanced pharmaceuticals that alter pain pathways, stressing the importance of integrating physiotherapy and psychosocial support for optimal outcomes in managing post-surgical knee pain. Dr. Khodam encourages questions and dialogue, inviting further discussion on the complex interplay between pain perception, management, and individual patient experiences.

DOI: 10.1302/3114-221729

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