Postoperative Pain Following Hospital Discharge after Knee Replacement Surgery: A Patient Survey

Abstract

SUMMARY Aim: To determine patients‘ pain experience and potential barriers to effective pain relief after discharge. Materials & methods: Cross-sectional survey at weeks 2 and 4 to consecutive patients after discharge following total knee arthroplasty on pain severity; use of pain medication and nonpharmacological strategies; side effects and perceptions of pain medication; adequacy of information; and patient satisfaction. Results: We recruited 105 participants (response rate: 94%). During the first 2 weeks at home, 40% of the participants experienced frequent severe–extreme pain and 20% of the participants reported that this was the most painful period. There was no/inadequate information on pain medication for 30% of the participants and nonpharmacological strategies for pain relief for 60% of the participants. Many participants had misconceptions about pain medications. More no to mild pain participants walked or exercised their knees longer daily, or were satisfied with pain relief since returning home, compared with moderate–severe pain participants. Conclusion: Following discharge for total knee replacement, there was suboptimal use of pain medication and nonpharmacological strategies, probably leading to unnecessary pain, reduced mobility, limited therapeutic exercise and patient dissatisfaction.

Acknowledgements

The authors would like to thank YH Teo, SWL Tai, TWS Yin, CHM Sim and the staff at Clinic B1A and the Department of Physiotherapy, Tan Tock Seng Hospital, Singapore, for their help with the study. The authors are indebted to all the individuals who participated in the study.

Financial & competing interests disclosure

This study was funded in part by the Singapore MOHNRC grant (MH 24:11/39-6/TR10NUR001). EY Chan was supported by an International Postgraduate Research Scholarship from the University of Sydney. The funding sources did not have any role in the study conceptualization, design and conduct; analysis and interpretation of data; manuscript writing; or decision to submit the article for publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

This study was funded in part by the Singapore MOHNRC grant (MH 24:11/39-6/TR10NUR001). EY Chan was supported by an International Postgraduate Research Scholarship from the University of Sydney. The funding sources did not have any role in the study conceptualization, design and conduct; analysis and interpretation of data; manuscript writing; or decision to submit the article for publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.