System
Effect
Gastrointestinal
Nausea, vomiting, constipation, ileus
Respiratory
Respiratory depression, hypoxia
Integumentary
Pruritus
Neurologic
Delirium, somnolence
Genitourinary
Urinary retention
Rehabilitation
Potential complications of rehabilitation include falls and additional injuries, such as fractures, dislocation, and soft tissue damage.
Procedures and Surgeries
As with any procedure or surgery, there may be risk of infection or failure.
Conclusion
Early patient performance in therapy is closely tied to how well postoperative pain is controlled. Uncontrolled pain has a detrimental implication on the patient’s ability to participate in therapy. As with any patient being admitted to a rehabilitation hospital, collaboration between the patient, family members, and interdisciplinary care team members including the surgeon, physiatrist, consulting physicians, nurses, therapists, social workers, and psychologist is critical to optimize early function and to maintain adequate pain control.
References
1.
Baratta JL, Gandhi K, Viscusi ER. Perioperative pain management for total knee arthroplasty. J Surg Orthop Adv. 2014;23(01):22–36. http://www.datatrace.com/e-chemtracts/emailurl.html?http://www.newslettersonline.com/user/user.fas/s=563/fp=20/tp=37?T=open_article,50073053&P=article
2.
Horlocker TT. Pain management in total joint arthroplasty: a historical review. Orthopedics. 2010;33(9 Suppl):14–9. http://www.ncbi.nlm.nih.gov/pubmed/20839717
3.
Maheshwari AV, Blum YC, Shekhar L, Ranawat AS, Ranawat CS. Multimodal pain management after total hip and knee arthroplasty at the ranawat orthopaedic center. Clin Orthop Relat Res. 2009;467(6):1418–23. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674168/pdf/11999_2009_Article_728.pdf
4.
Bono JV, Robbins CE, Mehio AK, Aghazadeh M, Talmo CT. Pharmacologic pain management before and after total joint replacement of the hip and knee. Clin Geriatr Med. 2012;28(3):459–70. http://www.ncbi.nlm.nih.gov/pubmed/22840308
5.
Feinglass J, Lee C, Durazo-Arvizu R, Chang R. Health status, arthritis risk factors, and medical care use among respondents with joint symptoms or physician diagnosed arthritis: findings from the 2001 behavioral risk factor surveillance system. J Rheumatol. 2005;32(1):130–6. http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=15630738&retmode=ref&cmd=prlinks\npapers3://publication/uuid/BA8AFED0-7206-430F-B1E6-0F315D498AD8
6.
Kurtz S. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg. 2007;89(4):780. http://jbjs.org/cgi/doi/10.2106/JBJS.F.00222
7.
8.
Macrae WA. Chronic pain after surgery. Br J Anaesth. 2001;87(1):88–98. http://www.ncbi.nlm.nih.gov/pubmed/11460816
9.
Kendell K, Saxby B, Farrow M, Naisby C. Psychological factors associated with short-term recovery from total knee replacement. Br J Health Psychol. 2001;6(1):41–52. https://www.ncbi.nlm.nih.gov/pubmed/14596737
10.
Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North America. 2005;23(1):21–36. http://linkinghub.elsevier.com/retrieve/pii/S0889853704001270
11.
Peelen LM, Ph D, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery. Anesthesiology. 2013;(4):934–944.
12.
Wylde V, Hewlett S, Learmonth ID, Dieppe P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain. 2011;152(3):566–72. http://www.ncbi.nlm.nih.gov/pubmed/21239114
13.
Bjørnholdt KT, Brandsborg B, Søballe K, Nikolajsen L. Persistent pain is common 1-2 years after shoulder replacement. Acta Orthop. 2014;86(1):1–7. http://www.ncbi.nlm.nih.gov/pubmed/25409254
14.
McCartney CJL, Nelligan K. Postoperative pain management after total knee arthroplasty in elderly patients: treatment options. Drugs Aging. 2014;31(2):83–91. http://www.ncbi.nlm.nih.gov/pubmed/24399578
15.
Sullivan M, Tanzer M, Reardon G, Amirault D, Dunbar M, Stanish W. The role of presurgical expectancies in predicting pain and function 1 year following total knee arthroplasty. Pain. 2011;152(10):2287–93. http://dx.doi.org/10.1016/j.pain.2011.06.014
16.
Sullivan M, Tanzer M, Stanish W, Fallaha M, Keefe FJ, Simmonds M, et al. Psychological determinants of problematic outcomes following total knee arthroplasty. Pain. 2009;143(1):123–9. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006396-200905000-00020
17.
VanDenKerkhof EG, Peters ML, Bruce J. Chronic pain after surgery: time for standardization? A framework to establish core risk factor and outcome domains for epidemiological studies. Clin J Pain. 2013;29(1):2–8. http://www.ncbi.nlm.nih.gov/pubmed/23211602