Complex regional pain syndrome as a complication following total knee arthroplasty: clinical significance and impact on functional outcomes
DOI:
https://doi.org/10.14739/2310-1210.2026.1.338147Keywords:
pain, endoprosthetics, knee jointAbstract
Aim. To evaluate the impact of complex regional pain syndrome (CRPS) on outcomes following primary and revision total knee arthroplasty (TKA). The study assesses the incidence, clinical manifestations, and functional consequences of CRPS, while evaluating current diagnostic and treatment approaches and the need for standardization.
Materials and methods. A systematic scientific review was conducted, covering literature from PubMed, Scopus, and Web of Science published between 2015 and 2025. Inclusion criteria focused on studies of adult patients undergoing TKA who developed CRPS diagnosed by IASP or Budapest criteria. The analysis targeted incidence, clinical manifestations, risk factors, diagnostic approaches, treatment efficacy, and impact on rehabilitation outcomes.
Results. CRPS remains a significant complication of TKA, with a reported incidence of approximately 0.2–2.0 % after primary procedures and 2–5 % following revision surgery. Clinical presentation is characterized by refractory pain, vasomotor dysfunction, and restricted range of motion, leading to significantly lower WOMAC and SF-36 scores and prolonged rehabilitation compared to uncomplicated TKA. Diagnosis remains challenging due to the lack of standardized early-detection protocols and symptom overlap with other complications, and underutilization of international diagnostic criteria. While multimodal management (pharmacotherapy, physiotherapy, and interventional techniques) is effective, its success is highly dependent on early initiation. High-quality evidence regarding CRPS in the specific context of revision TKA remains limited.
Conclusions. CRPS adversely affects functional outcomes after TKA, with higher prevalence observed in revision cases. The absence of standardized preventive measures and optimized therapeutic regimens highlights an urgent need for personalized rehabilitation strategies and the implementation of international diagnostic criteria in routine clinical practice. Further research is needed to establish precise diagnostic criteria, effective prevention strategies, and personalized therapeutic and rehabilitation approaches.
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Copyright (c) 2026 O. M. Sulima, V. M. Chornyi, O. Ye. Yuryk, V. V. Chornyi, Ye. M. Kudiienko, I. O. Bakumenko
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