title: Persistent post-surgical pain and neuropathic pain after total knee replacement.
abstract: OBJECTIVE
  To study the prevalence of persistent post-surgical pain (PPSP) and neuropathic pain (NP) after total knee replacement (TKR).
  
  
  METHODS
  MEDLINE and Embase databases were searched for articles published until December 2014 in English language. Published articles were included if they referred to pain that lasts at least 3 mo after primary TKR for knee osteoarthritis, and measured pain with pain specific instruments. Studies that referred to pain caused by septic reasons and implant malalignment were excluded. Both prospective and retrospective studies were included and only 14 studies that match the inclusion criteria were selected for this review.
  
  
  RESULTS
  The included studies were characterized by the heterogeneity on the scales used to measure pain and pre-operative factors related to PPSP and NP. The reported prevalence of PPSP and NP seems to be relatively high, but it varies among different studies. There is also evidence that the prevalence of post-surgical pain is related to the scale used for pain measurement. The prevalence of PPSP is ranging at 6 mo from 16% to 39% and at 12 mo from 13.1% to 23% and even 38% of the patients. The prevalence of NP at 6 mo post-operatively is ranging from 5.2% to 13%. Pre-operative factors related to the development of PPSP also differ, including emotional functioning, such as depression and pain catastrophizing, number of comorbidities, pain problems elsewhere and operations in knees with early grade of osteoarthritis.
  
  
  CONCLUSIONS
  No firm conclusions can be reached regarding the prevalence of PPSP and NP and the related factors due to the heterogeneity of the studies.
authors: Georgios I Drosos, Triantafilia Triantafilidou, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
authors: Georgios I
authors: GI
authors: Drosos
authors: Georgios I Drosos, Triantafilia Triantafilidou, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
authors: Triantafilia
authors: T
authors: Triantafilidou
authors: Georgios I Drosos, Triantafilia Triantafilidou, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
authors: Athanasios
authors: A
authors: Ververidis
authors: Georgios I Drosos, Triantafilia Triantafilidou, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
authors: Cristina
authors: C
authors: Agelopoulou
authors: Georgios I Drosos, Triantafilia Triantafilidou, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
authors: Theodosia
authors: T
authors: Vogiatzaki
authors: Georgios I Drosos, Triantafilia Triantafilidou, Athanasios Ververidis, Konstantinos Kazakos, Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
authors: Konstantinos
authors: K
authors: Kazakos
keywords: Chronic pain; Neuropathic pain; Pain; Persistent post-surgical pain; Post-operative pain; Total knee replacement