Preoperative widespread pain sensitization and chronic pain after hip and knee replacement: a cohort analysis.

Abstract:

:Chronic pain after joint replacement is common, affecting approximately 10% of patients after total hip replacement (THR) and 20% of patients after total knee replacement (TKR). Heightened generalized sensitivity to nociceptive input could be a risk factor for the development of this pain. The primary aim of this study was to investigate whether preoperative widespread pain sensitivity was associated with chronic pain after joint replacement. Data were analyzed from 254 patients receiving THR and 239 patients receiving TKR. Pain was assessed preoperatively and at 12 months after surgery using the Western Ontario and McMaster Universities Osteoarthritis Pain Scale. Preoperative widespread pain sensitivity was assessed through measurement of pressure pain thresholds (PPTs) at the forearm using an algometer. Statistical analysis was conducted using linear regression and linear mixed models, and adjustments were made for confounding variables. In both the THR and TKR cohort, lower PPTs (heightened widespread pain sensitivity) were significantly associated with higher preoperative pain severity. Lower PPTs were also significantly associated with higher pain severity at 12 months after surgery in the THR cohort. However, PPTs were not associated with the change in pain severity from preoperative to 12 months postoperative in either the TKR or THR cohort. These findings suggest that although preoperative widespread pressure pain sensitivity is associated with pain severity before and after joint replacement, it is not a predictor of the amount of pain relief that patients gain from joint replacement surgery, independent of preoperative pain severity.

journal_name

Pain

journal_title

Pain

authors

Wylde V,Sayers A,Lenguerrand E,Gooberman-Hill R,Pyke M,Beswick AD,Dieppe P,Blom AW

doi

10.1016/j.pain.0000000000000002

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

47-54

issue

1

eissn

0304-3959

issn

1872-6623

pii

00006396-201501000-00009

journal_volume

156

pub_type

杂志文章,随机对照试验

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