A substantial number of patients patients suffer from persistent pain or are unsatisfied after total knee arthroplasty (TKA).
This work aims to present the frequency of postoperative persistent pain and/or dissatisfaction as well as known causes and predictors.
The current literature is studied regarding the subject and is reviewed narratively.
Most postoperative problems did not arise from operation details, but from patient-related criteria, a lack of patient education and selection. The satisfaction correlates most strongly with the reduction of preoperative pain.
For a successful TKA, care should be taken that the following aspects are met preoperatively: clinically and radiologically advanced osteoarthritis, a patient age preferably older than 60 years, sufficient psychosocial resources to cope with postoperative stress, no opioid medication and realistic expectations after TKA. Postoperatively, patients with persistent pain or dissatisfaction should be checked for any prosthesis-related problems. If no prosthesis-related problems could be detected, the patients should be referred for interdisciplinary therapies.