Priority 6 from the Hip and Knee Replacement for Osteoarthritis PSP

UNCERTAINTY: What are the best techniques to control longer term chronic pain and improve long term function following hip and knee replacement?  (JLA PSP Priority 6)
Overall ranking 6
JLA question ID 0020/6
Explanatory note Not available for this PSP
Evidence

None available

Health Research Classification System category Musculoskeletal
Extra information provided by this PSP
Original uncertainty examples What should you do if the patients get pain post knee replacement. ~  What, if anything, improves CPSP after TKA  ~  Strategies for management of chronic post-surgical pain after joint replacement?  ~  How can we predict/diagnose/treat CRPS after TKR?  ~  Is  a CBT based pain management programme clinically and cost effective in the management  of hip and/or knee pain either before or after surgery  ~  role pre op conditioning CBT?  ~  help with "suboptimal" results of Hip replacement, leaving almost constant pain  ~  Is early (1st postop day) ambulation associated with an improved outcome in terms of functional status and pain?  ~ The link between neuropathic pain after TKR & tourniquet use during procedure?  ~  Do tourniquets and the duration of these, affect post-operative pain after knee replacement?  ~  Can changes to intra-operative techniques (e.g. tourniquet use/time; surgical technique) be altered to reduce the incidence of continuing pain following knee replacement  ~  Do tourniquets and the duration of these, affect post-operative motor function of the quadriceps after knee replacement?  ~  How do we best control post-operative pain and swelling in order to aid early rehabilitation?  ~  Why is pain control not better for knee replacements as this causes the patients a lot of distress?  ~  how can the pain be treated successfully early?
Submitted by Uncertainty identified by 1 patient/carer, and 14 clinicians
Outcomes to be measured Post-operative pain and function
PSP information
PSP unique ID 0020
PSP name Hip and Knee Replacement for Osteoarthritis
Total number of uncertainties identified by this PSP. 123  (To see more about the Top 10, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 27 March 2014