Data from: Analysis of early postoperative pain in the first and second knee in staged bilateral total knee arthroplasty: a retrospective controlled study

Objective: A retrospective analysis of early postoperative pain in the first and second knee in staged bilateral total knee arthroplasty (TKA) to provide a clinical evidence for the change of analgesic strategy.
Methods: From January 2009 to January 2013, 87 cases which meet the inclusion criterion were retrospectively reviewed. In stage TKA, the postoperative pain in the first and second knee at 24h, 48h, 72h after operation were compared using the visual analogue scale (VAS) score in the rest and maximum knee flexion position. The difference in pain scores (ΔVAS) was also compared between the second and first knee at different time intervals (less than 6 months, 6-12 months, more than 12 months). Results: The VAS scores in the second knee were significantly higher than those in the first knee at 24h, 48h after surgery, but with no difference at 72h. The ΔVAS in the group of less than 6 months was significantly higher than of those more than 6 months, and there was no difference in ΔVAS between group of 6-12 months and group of more than 12 months. Conclusions: Patient receiving staged bilateral TKA experiences greater postoperative pain within 48h after operation in the second knee than in the first knee, which can provide a clinical evidence to enhance the analgesic strategy in the second operation of the staged bilateral TKA. And for the management of postoperative pain in staged bilateral TKA, it’s better to recommend that the interval between two operations should be more than 6 months, which may reduce the postoperative pain in the second knee, improve patient satisfaction, and speed up patient‘s rehabilitation process.

研究目的：对分期双侧全膝关节置换术（staged bilateral total knee arthroplasty, TKA）中首次与再次置换膝关节的术后早期疼痛开展回顾性分析，旨在为镇痛方案的优化调整提供临床依据。
研究方法：选取2009年1月至2013年1月期间符合纳入标准的87例分期双侧TKA患者的临床资料进行回顾性分析。于术后24h、48h、72h三个时间点，采用视觉模拟评分法（visual analogue scale, VAS）评估首次与再次置换膝关节在静息状态及膝关节最大屈曲位的术后疼痛程度；同时按照两次手术的间隔时长分为<6个月、6~12个月、>12个月三组，比较不同组内再次与首次置换膝关节的疼痛评分差值（ΔVAS）。
研究结果：术后24h、48h时，再次置换膝关节的VAS评分显著高于首次置换膝关节，而术后72h时两组评分无显著差异；<6个月组的ΔVAS显著高于>6个月组，6~12个月组与>12个月组的ΔVAS无统计学差异。
研究结论：接受分期双侧全膝关节置换术的患者，术后48h内再次置换膝关节的术后疼痛程度显著高于首次置换膝关节，该结果可为分期双侧TKA二次手术的镇痛方案强化提供临床依据；针对分期双侧TKA的术后疼痛管理，建议将两次手术的间隔时长设置为超过6个月，此举可有效减轻再次置换膝关节的术后疼痛，提升患者满意度并加快患者康复进程。