Development and Persistence of Suspected Neuropathic Pain After Total Knee Arthroplasty in Individuals With Osteoarthritis

Fitzsimmons, Matthew; Carr, Eloise; Woodhouse, Linda J.; Bostick, Geoff P.

doi:10.1016/j.pmrj.2018.01.010

Cited by 29 publications

(36 citation statements)

References 22 publications

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“…10 Similar results were found in another prospective study following total knee arthroplasty. 5 The results of our study suggest that a significant amount of foot and ankle patients, both for acute injuries and chronic conditions, have NP symptoms. The implication of that on their results is yet to be evaluated.…”

Section: Discussionmentioning

confidence: 59%

“…A recent general-population health survey done in the United States found that as high as 15.7% of the patients reporting to have pain and 10% of all the responders had a probable NP with a higher tendency in certain ethnic groups (blacks and Hispanic). 2 The study of NP in orthopedic conditions has started with focusing mainly in osteoarthrosis (OA) of the knee 1,5,7,14,16 and spinal pathologies 15,23 but has now progressed to evaluate the prevalence and the implications of NP in other common orthopedic conditions including hip lesions, 13 rotator cuff tear, 9 carpal tunnel syndrome, 18 etc. These studies have found up to 34% of the patients with knee OA have NP, 10.5% of the patients with carpal tunnel syndrome, 15.8% with rotator cuff tears, and as high as 53% of patients with chronic back pain.…”

Section: Introductionmentioning

confidence: 99%

“…17 Furthermore, it was shown the patients with NP had inferior results following total knee arthroplasty (TKA), with significantly higher visual analog scale (VAS) pain scores and lower pain detection thresholds, 10 though another study with similar inferior results for patients with NP found that the presence of preoperative NP did not predict higher pain scores postoperatively. 5 Accurate classification of pain phenotype using clinically feasible tools has the potential to improve pain management. The painDETECT score is one of several methods to clinically diagnose NP.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Neuropathic Pain Symptoms in Foot and Ankle Patients

et al. 2019

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Background: The management of pain in patients with foot and ankle pathology can be challenging. Cumulative data suggest that, in addition to nociceptive mechanisms, other neuropathic mechanisms can contribute to pain in a subset of people with orthopedic conditions, and can be found in 10.5% to 53% of patients with chronic pain, depending on the location of the pathology. Preoperative diagnosis of neuropathic pain (NP) can potentially change decision making and management of foot and ankle pathologies. Methods: We used a validated patient-reported pain questionnaire (painDETECT) as a cross-sectional study to investigate the prevalence of NP symptoms in a population of patients undergoing foot and ankle surgery. A total of 533 patients were prospectively included and completed the painDETECT questionnaire. Results: Sixty-six patients (12.4%) were classified as having a component of NP symptoms according to their painDETECT score. Current smokers (23.2%) had a significantly higher rate of developing NP symptoms than current nonsmokers (11.1%) ( P = .016). The location of the pathology and obesity had a moderate effect on the prevalence of NP symptoms. Patients with ankle-level pathology, excluding tarsal tunnel syndrome, had a marginally increased risk of having NP symptoms (15.4%) compared to patients with forefoot pathologies, excluding Morton’s neuroma (7.5%, P = 0.06). Obesity also had a moderate effect on the NP risk, with 15.6% risk of NP symptoms for patients with BMI of 30 or more compared to 10% risk for patients with a BMI of less than 30 ( P = .06). Patients with NP symptoms reported significantly higher levels of current pain (7.2 vs 4.6, P < .001). Conclusion: A considerable number of patients with foot and ankle problems requiring surgery had a neuropathic component of pain. Evaluation of their risk factors and level of pain may help with the diagnosis, decision making, and pain control. Further research is needed to evaluate the effect of preoperative NP on the short- and long-term results of surgeries. Level of Evidence: Level II, prospective cohort survey study.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Neuropathic Pain Symptoms in Foot and Ankle Patients

et al. 2019

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“…Although, previous studies did not evaluate the outcomes after TKA in patients with neuropathic pain, the present study demonstrated the key role of preoperative possible neuropathic pain on postoperative pain. Using the Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale, Fitzsimmons et al [19] reported that suspected neuropathic pain was present in 35.5% of pre-TKA patients, and in 23.6% of OA patients at 6 months post-TKA. Patients scoring 12 or greater on the scale were de ned as having suspected neuropathic pain [19].…”

Section: Discussionmentioning

confidence: 99%

“…Using the Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale, Fitzsimmons et al [19] reported that suspected neuropathic pain was present in 35.5% of pre-TKA patients, and in 23.6% of OA patients at 6 months post-TKA. Patients scoring 12 or greater on the scale were de ned as having suspected neuropathic pain [19]. If surgeons recognize the presence of possible neuropathic pain before TKA, careful evaluation, including of spinal disease, is needed to avoid chronic postoperative knee pain.…”

Section: Discussionmentioning

confidence: 99%

Possible Neuropathic Pain in Patients With Osteoarthritis of the Knee Before and After Total Knee Arthroplasty

Hasegawa

Tone

Naito

et al. 2021

Preprint

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Background: Although osteoarthritis (OA) is traditionally considered to be nociceptive, our objective was to examine neuropathic pain in the knees of OA patients using the pain DETECT questionnaire (PDQ).Methods: A total of 180 knees in 158 consecutive patients who underwent total knee arthroplasty (TKA) were enrolled. The prevalence of neuropathic pain, unclear pain and nociceptive pain was determined before and after TKA. Knee pain was evaluated using a numerical rating scale (NRS). All patients were evaluated preoperatively and 6 months postoperatively. Neuropathic pain and unclear pain were grouped together as possible neuropathic pain. The relationship between possible neuropathic pain and pain intensity was evaluated.Results: Before TKA, neuropathic pain and unclear pain were found in 10 and 30 knees, respectively. The remaining 140 knees were categorized as nociceptive pain. After TKA, the numbers of knees with neuropathic and unclear pain decreased to one and five, respectively. The prevalence of possible neuropathic pain decreased significantly from 22.2% to 3.3% (p < 0.001) after surgery. Among the six knees with possible neuropathic pain postoperatively, four had possible neuropathic pain preoperatively as well, while the remaining two patients had been classified as nociceptive pain preoperatively (p = 0.021). Knees with postoperative possible neuropathic pain had higher postoperative NRS scores than those with nociceptive pain (p = 0.011).Conclusions: The prevalence of possible neuropathic pain decreased significantly after TKA, however, preoperative possible neuropathic pain might affect the presence of persistent postoperative pain.

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Extracapsular Stabilization Using Synthetic Material

Holsworth¹

2021

Complications in Canine Cranial Cruciate Ligament Surgery

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Development and Persistence of Suspected Neuropathic Pain After Total Knee Arthroplasty in Individuals With Osteoarthritis

Abstract: II.

Cited by 29 publications

References 22 publications

Prevalence of Neuropathic Pain Symptoms in Foot and Ankle Patients

Prevalence of Neuropathic Pain Symptoms in Foot and Ankle Patients

Possible Neuropathic Pain in Patients With Osteoarthritis of the Knee Before and After Total Knee Arthroplasty

Extracapsular Stabilization Using Synthetic Material

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