Guidelines for Perioperative Pain Management in Total Knee Arthroplasty in China (2022)

Total knee arthroplasty (TKA) is currently the main treatment for end-stage knee disease. Moderate to severe pain often occurs after TKA, which seriously affects postoperative rehabilitation, patient satisfaction and overall outcome. Multimodal analgesia is considered as the ideal solution. There is no guideline for perioperative pain management in TKA in China. On the basis of the discussions by experts from Joint Surgery Branch of Chinese Orthopaedic Association and Joint Surgery Branch of Beijing Orthopaedic Association, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the quality of evidence and the strength of recommendations. Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was strictly followed to report the guideline. Finally, 20 evidence-based recommendations were formulated based on the 20 most concerning clinical problems among orthopaedic surgeons according to evidence retrieval, quality evaluation of body evidence, and establishment of direction and intensity of recommendations through four rounds of Delphi surveys. This guideline was developed to improve the standardization of perioperative pain management in TKA in China.