Pain Trajectories Identify Patients at Risk of Persistent Pain After Knee Arthroplasty: An Observational Study

Lavand’homme, Patricia; Grosu, Irina; Thienpont, Emmanuel

doi:10.1007/s11999-013-3389-5

Cited by 110 publications

(92 citation statements)

References 20 publications

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“…P.M. Lavand'homme с соавторами обнаружили, что в течение первой недели после тотального эндопротезирования коленного сустава в под-группе пациентов, у которых боль имела чет-кий нейропатический компонент, наблюдался ее максимальный уровень при движениях, в то время как различия в выраженности боли не об-наруживались в состоянии покоя [14].…”

Section: окончание таблицы 4/unclassified

“…Тем не менее, все они были обучены выполнять операцию методично и в соответ-ствии принципами малоинвазивной хирургии, таким как минимальная диссекция мягких тка-ней, уменьшение длины доступа до минимально необходимого, предотвращение чрезмерного натяжения мягких тканей путем использования принципа подвижного окна на всех этапах опе-рации, избегание выворачивания надколенника или полного подвывиха плато большеберцовой кости кпереди и т.д. Таким образом, дальнейшее изучение обсуж-даемого немаловажного аспекта артропластики коленного сустава поможет выделить подгруп-пу пациентов с повышенным риском развития выраженного послеоперационного болевого синдрома и, соответственно, индивидуализи-ровать как профилактические, так и лечебные анальгетические мероприятия на пред-, интра-и послеоперационном этапах лечения [14,37].…”

Section: окончание таблицы 4/unclassified

“…В таблице 1 представлен список вероятных прогностических переменных, который был составлен на основании анализа научных пуб-ликаций, посвященных изучению послеопе-рационного болевого синдрома у пациентов, перенесших тотальное эндопротезирование ко-ленного сустава [14,18,24,26,29]. Для посто-янных измерений без установленных границ изучаемых характеристик разделение по меди-ане использовалось для сравнения траекторий боли у пациентов с относительно высокими и низкими показателями.…”

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What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

Сараев

Lindberg

Гэй

et al. 2017

Traumatology and Orthopedics of Russia

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Purpose – to describe the relationship of selected socio-demographic, clinical, and surgical factors with the severity and patterns of postoperative pain during the first three days following total knee arthroplasty.Material and methods. The sample included 100 patients (93 women and 7 men; mean age 63.5±7.8 years) with osteoarthritis admitted for primary total knee arthroplasty. Prior to surgery, standard measures were used to assess preoperative pain and other symptoms, clinical manifestations of osteoarthritis, functional status of the knee, comorbidities, functional abilities, quality of life, and other patient characteristics. Physical, biochemical and surgical parameters of the perioperative period were also recorded. Patterns of daily changes in postoperative pain characteristics were investigated with the use of individual diaries. Results. All the analyzed indicators of postoperative pain progressively decreased during the three days after surgery (р0,001), including the number of daily hours of moderate to severe pain (р0,001). Pain levels were generally higher among women than among men (р = 0,009). Of the analyzed preoperative factors, higher levels postoperative pain were correlated with higher levels of anxiety (р = 0,029) and preoperative pain intensity (р = 0,029). Among the perioperative factors, surgery duration longer than 90 minutes was associated with higher levels of postoperative pain in activity (р = 0,012) and more hours of moderate/severe pain (р = 0,008). Characteristics of postoperative pain were unrelated to level of patient education, social or family status, employment, lifestyle, or any other clinical or laboratory variables.Conclusion. Of the many factors previously associated with postoperative pain, only gender, anxiety and level of preoperative pain confirmed their importance in this study. Among the perioperative factors, surgery duration, which varied by the type of implant, was significantly associated with postoperative pain levels.

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Section: окончание таблицы 4/unclassified

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What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

Сараев

Lindberg

Гэй

et al. 2017

Traumatology and Orthopedics of Russia

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“…Neuropathic pain affects about 11 % of patients undergoing primary TKA and has its peak incidence between 6 weeks and 3 months postoperatively [50]. Injury to the infrapatellar branch of saphenous nerve has been implicated as a common extra-articular cause of persistent knee pain [51,52].…”

Section: Referred Sourcesmentioning

confidence: 99%

“…Younger age and female gender are factors that seem to be associated with a more intense postoperative pain [50]. Similarly, patients with history of migraine, fibromyalgia, and irritable bowel syndrome might be predisposed to chronic pain after TKR.…”

Section: Psychosocial Factorsmentioning

confidence: 99%

Towards an understanding of the painful total knee: what is the role of patient biology?

Preston

Petrera

Kim

et al. 2016

Curr Rev Musculoskelet Med

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Total knee arthroplasty (TKA) remains the treatment of choice for end-stage osteoarthritis of the knee.With an aging population, the demand for TKA continues to increase, placing a significant burden on a health care system that must function with limited resources. Although generally accepted as a successful procedure, 15-30 % of patients report persistent pain following TKA. Classically, pain generators have been divided into intra-articular and extra-articular causes. However, there remains a significant subset of patients for whom pain remains unexplained. Recent studies have questioned the role of biology (inflammation) in the persistence of pain following TKA. This article aims to serve as a review of previously identified causes of knee pain following TKA, as well as to explore the potential role of biology as a predictor of pain following knee replacement surgery.

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What Have We Learned About the Course of Clinical Outcomes After Total Knee or Hip Arthroplasty?

Wieczorek

Rotonda

Guillemin

et al. 2020

Arthritis Care & Research

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Objective. To review homogeneous subgroups with a distinct course of clinical outcomes, to review the course of clinical outcomes in the study population as a whole, where applicable, and to determine the patient characteristics associated with the distinct courses after total knee or hip arthroplasty. Methods. MEDLINE and PsycInfo databases were searched for relevant studies. Selection criteria were patients ≥18 years old, patients at high risk of or diagnosed with knee or hip osteoarthritis, studies aiming to identify homogeneous subgroups with distinct trajectories or describe the mean change of clinical outcomes, and methodology and analysis designed to identify trajectories (longitudinal design and repeated measures). Results. Of the 5,128 abstracts retrieved, 23 met inclusion criteria. Most studies (12 of 23) focused on the mean course of outcomes after knee arthroplasty, and the most frequent outcomes reported were pain and physical function. Statistical approaches used, the number of trajectories, and predictors identified were heterogeneous across studies. Strong evidence was found that female sex, a high body mass index, poor mental health, a high number of painful sites, high preoperative pain level, a low preoperative lower-extremity functioning, and knee arthroplasty were predictors of bad evolution. Conclusion. Few studies have used trajectory analysis to describe the course of clinical outcomes in homogeneous subgroups of patients. Yet this approach could lead to the identification of predictors of poor postsurgery outcomes that are specific to patients and thus to earlier identification of poor responders to total arthroplasty.

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Pain Trajectories Identify Patients at Risk of Persistent Pain After Knee Arthroplasty: An Observational Study

Abstract: BackgroundPersistent postsurgical pain is a major source of dissatisfaction after knee arthroplasty. Postoperative pain trajectories allow a dynamic view of pain resolution after surgery and might help to identify patients at risk for persistent pain.

Cited by 110 publications

References 20 publications

What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

Towards an understanding of the painful total knee: what is the role of patient biology?

What Have We Learned About the Course of Clinical Outcomes After Total Knee or Hip Arthroplasty?

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