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The association between pre-operative pain sensitisation and chronic pain after knee replacement: an exploratory study.
- Source :
-
Osteoarthritis and cartilage [Osteoarthritis Cartilage] 2013 Sep; Vol. 21 (9), pp. 1253-6. - Publication Year :
- 2013
-
Abstract
- Objective: Chronic pain after total knee replacement (TKR) is a prevalent condition, affecting about 20% of patients. The aim of this study was to explore the relationship between pre-operative pain thresholds and chronic pain after TKR.<br />Design: Patients listed for a TKR because of osteoarthritis participated in a Quantitative Sensory Testing (QST) session prior to surgery. Pressure pain thresholds (PPTs) and hot pain thresholds were assessed at the osteoarthritic knee and the forearm. Patients were followed-up at 1-year after TKR, and the severity of pain in the replaced knee was assessed using the WOMAC Pain score. Pre-operative median QST thresholds were compared to thresholds from a normative database collected from 50 people with no knee pain. The relationship between pre-operative pain thresholds and pain severity post TKR were tested using correlations.<br />Results: Fifty-one patients participated in a pre-operative QST session and completed a 1-year WOMAC Pain score. Pre-operatively, patients demonstrated evidence of localised (knee) and widespread (forearm) pain sensitisation in response to pressure stimuli compared to healthy participants. Pre-operative PPTs at the forearm were found to be significantly correlated with 1-year WOMAC Pain scores (r = 0.37, P = 0.008).<br />Conclusions: This study provides preliminary evidence that pre-operative widespread pain sensitisation, measured using pressure algometry, may be associated with chronic pain after TKR. Further research is needed to explore the predictive value of an assessment of pre-operative widespread pain sensitisation in identifying who is likely to develop chronic pain after TKR.<br /> (Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Arthralgia diagnosis
Arthralgia etiology
Chronic Pain diagnosis
Female
Follow-Up Studies
Hot Temperature adverse effects
Humans
Male
Middle Aged
Osteoarthritis, Knee complications
Osteoarthritis, Knee surgery
Pain Measurement
Pain, Postoperative diagnosis
Pain, Postoperative etiology
Predictive Value of Tests
Preoperative Care
Pressure adverse effects
Arthralgia physiopathology
Arthroplasty, Replacement, Knee adverse effects
Chronic Pain physiopathology
Osteoarthritis, Knee physiopathology
Pain Threshold physiology
Pain, Postoperative physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1522-9653
- Volume :
- 21
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Osteoarthritis and cartilage
- Publication Type :
- Academic Journal
- Accession number :
- 23973138
- Full Text :
- https://doi.org/10.1016/j.joca.2013.05.008