Assessing the value of systematic screening and early management of neuropathic pain after total knee arthroplasty. A single-center retrospective study

Background Neuropathic pain is a frequent component of chronic postoperative pain after total knee arthroplasty (TKA) and may remain underdiagnosed. This study evaluated the systematic screening and early management of postoperative neuropathic pain after TKA and described established CPOP risk factors within the affected population.Hypothesis The study hypothesis was that early identification and targeted management of neuropathic pain after TKA may lead to favorable clinical outcomes.Patients and methods A retrospective, observational, single-center study analyzed patients undergoing total knee arthroplasty by the same surgeon from March 2018 to December 2021. Patients with postoperative neuropathic pain defined as a DN4 score≥4/10 were followed prospectively and treated. The primary aim was neuropathic pain resolution, defined as a DN2 score Results A cohort of 402 patients who underwent TKA was enrolled. Postoperatively, 58/402 (14.4%) developed neuropathic pain; follow-up was completed for 42 patients. Women were significantly overrepresented in the analyzed NP cohort (37/42, 88.1%; p Discussion The observed NP rate and CPOP risk-factor profile were consistent with the literature. Nearly two-thirds of analyzed patients met the predefined recovery criteria following systematic screening and multidisciplinary management. However, the absence of a control group precludes causal attribution of these outcomes to the pathway. Prospective controlled studies are required to determine its effect on recovery and symptom control.Level of evidence IV.