Complex regional pain syndrome: the orthopaedic surgeon’s perspective
Seance of wednesday 04 march 2026 (Les algodystrophies : des pathologies sous-estimées, sous-évaluées et sous traitées)
DOI number : 10.26299/msga-sh53/emem.2026.10.03
Abstract
Complex regional pain syndrome (CRPS) is an uncommon but challenging complication in orthopaedic surgery. Its multifactorial pathophysiology and heterogeneous clinical presentation often make persistent postoperative pain difficult to interpret. This presentation discusses CRPS from the orthopaedic surgeon’s perspective through four clinical scenarios: trauma, elective surgery, revision surgery, and nerve injury (CRPS type II).
In trauma settings, prolonged immobilization and delayed mobilization appear to be major risk factors for CRPS development. In planned orthopaedic surgery, preoperative pain intensity and central sensitization are strongly associated with persistent postoperative pain. Revision surgery represents a particularly high-risk situation, where distinguishing between persistent mechanical pathology and centralized pain is essential. In CRPS type II, identification of a nerve lesion may justify targeted surgical exploration.
For orthopaedic surgeons, surgical indication and operative timing remain the most important modifiable factors influencing outcomes.
In trauma settings, prolonged immobilization and delayed mobilization appear to be major risk factors for CRPS development. In planned orthopaedic surgery, preoperative pain intensity and central sensitization are strongly associated with persistent postoperative pain. Revision surgery represents a particularly high-risk situation, where distinguishing between persistent mechanical pathology and centralized pain is essential. In CRPS type II, identification of a nerve lesion may justify targeted surgical exploration.
For orthopaedic surgeons, surgical indication and operative timing remain the most important modifiable factors influencing outcomes.