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

Abstract

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.

Impact of pain sensitisation on the quality of life of patients with knee osteoarthritis

“…Finally, the absolute number of patients who met any one of the criteria for ‘pain sensitisation’ was quite small, which may have impacted our findings. A low prevalence of neuropathic-like phenotype has been reported in other Asian cohorts 40 41. Perhaps, a certain proportion of patients with KOA who have pain sensitisation may have been excluded from offering arthroplasty during clinical assessments.…”

Evaluación funcional de pacientes con osteoartritis que asistieron al Centro de Rehabilitación Integral Especializado Guayaquil

“…Adicionalmente se analizó que los pacientes presentaron de mucho a muchísimo dolor, equivalente al estudio que se realizó en la Universidad Mie de Tsu City, Japón, en que el dolor fue una de las dimensiones que más afectó, siendo la característica más evidenciada y de forma notoria en casos con osteoartritis y que terminó siendo uno de los principales síntomas en manifestarse y el motivo por el cual se acudió al médico (20).…”

Different Prevalence of Neuropathic Pain and Risk Factors in Patients with Knee Osteoarthritis at Stages of Outpatient, Awaiting and after Total Knee Arthroplasty

“…In addition, Hasegawa et al . find that possible NP existed in 22.2% patients before TKA and decreased to 3.3% after TKA 9 . The increasing data on the reported prevalence of NP vary from 5.4% to 28% 6,10–12 in patients with KOA and 0% to 15.3% of patients after TKA 13–15 .…”

“…find that possible NP existed in 22.2% patients before TKA and decreased to 3.3% after TKA. 9 The increasing data on the reported prevalence of NP vary from 5.4% to 28% 6 , 10 , 11 , 12 in patients with KOA and 0% to 15.3% of patients after TKA. 13 , 14 , 15 However, the prevalence of NP at different treatment stages, including the outpatient stage and the stages of awaiting and after TKA has not been compared in one cohort.…”