Surgical technology international
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Due to the rising concern regarding excessive opioid use, several alternative pain control options have been developed for total knee arthroplasty (TKA). Therefore, the purpose of this article was to review non-narcotic treatments to manage pain after TKA. Specifically, we evaluated: 1) acetaminophen; 2) cyclooxygenase-2 (cox-2) inhibitors; 3) gabapentinoids; 4) dexmedetomidine, 5) nerve blocks; 6) local analgesic infiltration; 7) transcutaneous electrical nerve stimulation (TENS); and 8) perioperative bracing. ⋯ The optimal solution for postoperative TKA pain management has yet to be determined. Although several options exist, many of them have been associated with adverse effects limiting their generalizability. Knee braces, however, have been identified as one potentially successful option. Importantly, knee braces are safe for the majority of patients and should be widely recommended for patient use.
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Since arthritis of the knee is one of the most common pathologies in industrialized nations, there has been a growing interest in fast-track total knee arthroplasty (TKA). However, while one of the main concerns is the role of a tourniquet, the available data are inconclusive. ⋯ These results suggest that there is no strongly significant link between the postoperative outcome and the use of a tourniquet. However, further studies will be needed to determine whether a tourniquet may have some other impact on TKA.