The importance of regional anesthesia also has to be highlighted, as it is associated with a lower risk of developing CRPS [18].

From the surgical point of view, the most important factor is performing the surgical procedure with the least possible iatrogenic trauma and avoidance of nerve damage in with the intent to reduce the incidence of iatrogenic neuropathic pain. A further perioperative aspect to consider is the intra-articular injection of analgesics that proved to be very effective in reducing acute postoperative pain and facilitating mobility [19]. During postoperative care, ensuring that the patient is painfree lies within the surgeons’ responsibility, and aggressive pain therapy should be applied when necessary to prevent chronic complications [8].

Vitamin C seems to show protective effects regarding the incidence of CRPS. this has been shown by Zollinger et al. in two randomized trials of patients with wrist fractures in which a 500 mg daily dosage was given for 50 days. this may or may not apply for TKR [20, 21].

Treatment options are divided into physical, pharmacological, and surgical therapy. First-line treatment is physiotherapy, which in early stages aims for edema control, prevention of joint contractures, and reestablishment of voluntary motor function. Physiotherapy provides good response in a considerable number of patients justifying its use [22].