Total Knee Arthroplasty: Opioid-Free Analgesia in a Patient with Opioid-Induced Hyperalgesia: A Case Report
Kadado A, Slotkin S, Akioyamen NO, El-Alam A, and North WT. Total Knee Arthroplasty: Opioid-Free Analgesia in a Patient with Opioid-Induced Hyperalgesia: A Case Report. JBJS Case Connect 2020; 10(3):e2000024.
JBJS Case Connect
CASE: Pain control after total knee arthroplasty (TKA) remains a significant challenge, especially in the context of certain patient-specific factors. We present a case of a 59-year-old woman with opioid-induced hyperalgesia who was referred for left knee pain and end-stage tricompartmental degenerative joint disease after failure of conservative management. We outline an approach to control postoperative pain in patients undergoing TKA who have severe opioid contraindications.
CONCLUSIONS: TKA and rehabilitation with a 6-year follow-up period was accomplished using a multimodal nonopioid approach, consisting of a combination of gabapentin, acetaminophen, ketorolac, meloxicam, methocarbamol, a tunneled femoral nerve catheter, and periarticular injection.