#97: New Case Series – Significant Differences In BOTH Straight Leg Raise (SLR) And Pain Pressure Threshold (PPT) After Total Knee Arthroplasty (TKA) Suggests That Post Operative Pain Is Potentially Neuropathic


This month’s Research Commentary features a Research Poster presented at the AAOMPT October 2023 Conference in St. Louis, MO.  The primary author was Amy Morris PT, DPT, COMT, OCS, FAAOMPT. Co-authors included Chris Showalter PT, DPT, OCS, FAAOMPT and Jody Musick, PT, DPT, COMT, OCS, FAAOMPT.

Background

According to the U.S. National Institute of Health, Total Knee Arthroplasty procedures surged by 177% to 480,958 between 2000 and 2019 and are projected to rise another 24% between 2020-2025, 139% by 2040, and 469% by 2060.

Clearly, this is an important patient population to consider for physical therapists, particularly since up to 20% of TKA patients will continue to experience pain greater than 1 year post-operatively.
The presence of neuropathic pain following TKA has been studied through the use of various subjective outcome measures including the painDETECT questionnaire (PDQ).

However, previous research has failed to determine any objective “gold standard” for identifying neuropathy as it relates to nociceptive (any pain perceived by the patient) or neuropathic pathways (pain coming specifically from nerves). Additional research
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