Diagnosis and management of neuropathic pain post-total knee replacement: A systematic review

doi:10.5312/wjo.v17.i6.119956

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Publication Name

World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Systematic Reviews

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Jun 18, 2026; 17(6): 119956
Published online Jun 18, 2026. doi: 10.5312/wjo.v17.i6.119956

Diagnosis and management of neuropathic pain post-total knee replacement: A systematic review

Simon Dias, Samantha Ashworth, Sarah McGonagle, Pip Divall, Joseph Dias

Simon Dias, Sarah McGonagle, Department of Medicine, Sheffield Teaching Hospitals, Sheffield S5 7AU, United Kingdom

Samantha Ashworth, Department of Anaesthesia, East Suffolk and North Essex NHS Foundation Trust, Ipswich IP4 5PD, Suffolk, United Kingdom

Pip Divall, Department of Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, United Kingdom

Joseph Dias, Department of Trauma & Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, United Kingdom

Author contributions: Dias S, Ashworth S, McGonagle S, Divall P, and Dias J wrote and edited the paper; Dias S, Ashworth S, and McGonagle S collected data, attended regular conflict resolution meetings and cleaned the data, confirmed and checked quotes, extracted the final data and generated the tables; Dias S and Dias J designed the research questions, method and analysis, prepared all tables and generated the figures, and all managed it on weekly meetings. All authors read the final paper and suggested corrections.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Simon Dias, MBBS, MRCP, Department of Medicine, Sheffield Teaching Hospitals, Herries Road, Sheffield S5 7AU, United Kingdom. simon.dias2@nhs.net

Received: February 11, 2026
Revised: March 10, 2026
Accepted: May 9, 2026
Published online: June 18, 2026
Processing time: 126 Days and 19.3 Hours

Core Tip

Core Tip: Total knee replacements (TKRs) are a common procedure and the incidence of neuropathic pain post-TKR has been reported as up to 50%. The literature on diagnosis and management of neuropathic pain post-TKR was systematically reviewed. Seven eligible studies had different case definitions, severity assessment and outcomes reported. Current evidence does not support clear treatment recommendations for these patients. A possible logical pathway based on the current literature is outlined, but needs evidence of effectiveness for each step.