Nerve Burial for Preventing Neuralgia After Total Knee Arthroplasty

Exclusion Criteria

• •Age \<18 or \>80 years
• •Known pre-operative diagnosis of neuralgia, complex regional pain syndrome, or neuropathy, about the operative lower extremity
• •Known pre-operative psychiatric disorder requiring medication
• •Previous surgery about the operative knee
• •BMI \> 40 kg/m2 (potential increased risk of soft tissue dissection through adipose)
• •Ongoing pre-operative narcotic use in excess of 20 mg morphine equivalents per day for at least one month or pre-operative intravenous drug use (increased potential for complex regional pain syndrome and neuralgia, increased likelihood to require greater post-operative analgesia)
• •Ongoing pre-operative use of neuropathic pain medications (gabapentin, pregabalin, amitriptyline, etc.)
• •Medical comorbidities (American Society of Anesthesiologists grade \> 3 or deemed unfit by consulting internist) precluding elective TKA
• •Significant language barrier (reading comprehension less than 8th grade reading level) or mental condition precluding accurate self-assessment of knee pain or function.
• •Severe medication allergies to permissible post-operative analgesics (acetaminophen, tramadol, oxycodone, oxycontin, dilaudid)