The Influence of Chronic Pain on Postoperative Pain and Function After Hip Surgery: A Prospective Observational Cohort Study

Erlenwein, Joachim; Przemeck, Michael; Degenhart, Astrid; Budde, Stefan; Falla, Deborah; Quintel, Michael; Pfingsten, M.; Petzke, Frank

doi:10.1016/j.jpain.2015.10.013

Cited by 28 publications

(17 citation statements)

References 46 publications

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“…These findings may support the need for the integration of psychological support during rehabilitation after surgery for patients who fall into high-risk groups. 18 Preoperative pain intensity (NRS) and the BMI were the only independent risk indicators for poor function 6 months after surgery (CPG – disability points). These findings support the assumption of a close relation between physical function and pain.…”

Section: Discussionmentioning

confidence: 99%

“…Although preoperative chronic pain has been identified as a relevant factor for slower rehabilitation in the immediate postoperative period, at the current follow-up, there was no effect on reduced function (CPG – disability points) and life quality (SF 12) 6 months after surgery in comparison between patients with and without other chronic pain. 18 …”

Section: Discussionmentioning

confidence: 99%

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Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

Erlenwein¹,

Müller²,

Falla³

et al. 2017

JPR

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PurposeThe development of persistent postoperative pain may occur following surgery, including total hip replacement. Yet, the prevalence may depend on the definition of persistent pain. This observational cohort study explored whether the prevalence of persistent pain after total hip replacement differs depending on the definition of persistent pain and evaluated the impact of ongoing pain on the patient’s quality of life 6 months after surgery.Patients and methodsPre- and postoperative characteristics of 125 patients undergoing elective total hip replacement were assessed and 104 patients were available for the follow-up interview, 6 months after surgery.ResultsSix months after surgery, between 26% and 58% of patients still reported hip pain – depending on the definition of persistent pain. Patients with moderate-to-severe persistent pain intensity (>3 on a numerical rating scale) were more restricted in their daily life activities (Chronic Pain Grade – disability score) but did not differ in reported quality of life (Short-Form 12) from those with no pain or milder pain intensity. Maximal preoperative pain intensity and body mass index were the only independent factors influencing daily function 6 months after total hip replacement.ConclusionThese findings support a high prevalence of persistent postoperative pain after total hip replacement and a large variability depending on the definition used. There was a close relation between physical functioning and pain as well as relevance of the patient’s psychological state at the time of the operation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

Erlenwein¹,

Müller²,

Falla³

et al. 2017

JPR

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“…Inadequate postoperative pain management can lead to acute effects, including immune system suppression, decreased mobility, and increased risk for deep vein thrombosis and pulmonary embolism [4,5]. Most of all, poor pain management results in patient's reluctance to mobilize the joint, hence poor functional recovery after surgery [6].…”

Section: Introductionmentioning

confidence: 99%

Comparison between local infiltration analgesia with combined femoral and sciatic nerve block for pain management after total knee arthroplasty

et al. 2020

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Background: Total knee arthroplasty (TKA) is usually associated with moderate to severe postoperative pain. Peripheral nerve block (PNB) and local infiltration analgesia (LIA) are two major methods for postoperative analgesia. Femoral nerve block (FNB) leads to residual posterior knee pain; thus, currently sciatic nerve block (SNB) and LIA are two major options for supplementing FNB. However, the efficacy and safety of LIA compared with combined femoral and sciatic nerve block still remain controversial. Here, we conducted a study to analyze the postoperative analgesic efficacy of these two methods. Method: Two hundred six patients undergoing TKA were enrolled in a retrospective cohort study. The patients received either PNB or LIA. All patients in PNB group were conducted combined femoral and sciatic nerve block. All patients were encouraged to use patient-controlled analgesia (PCA) after surgery. The postoperative visual analog scale (VAS) at rest or with movement during the first 24 h and 48 h was recorded. We analyzed the VAS of 24 h, VAS of 48 h, opioid consumption, and adverse effects between PNB group and LIA group. Chi-square test and nonparametric test were used in this study. Results: There were 82 patients in the PNB group and 124 patients in the LIA group. The patients' characteristics such as age, height, weight, and ASA showed no significant difference (P > 0.05). No significant differences were found (P > 0.05) between the two groups regarding VAS score at rest or with movement. The LIA group had less opioid consumption than the PNB group but without significant difference (P > 0.05). In both groups, the most common side effect was nausea, and the side effects showed no significant differences between groups (P > 0.05). Conclusion: Local infiltration analgesia provided a similar analgesic effect and complications compared with combined femoral and sciatic nerve block in the short term. Considering less opioid consumption with local infiltration analgesia though without significant difference and its convenience, local infiltration analgesia provided better postoperative analgesia.

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“…We are aware of studies concerning postarthroplasty acute pain either on TKA31–40 or on THA 28,29. Three other studies centered on the comparison between TKA and THA,41,42 but did not perform multivariate predictive analyses. We already mentioned the study by Aarons et al43 addressing THA and TKA, taking into account the acute pain period (7 days after surgery).…”

Section: Discussionmentioning

confidence: 99%

“…Concerning prediction of acute pain after THA and TKA, we are aware of two studies wherein TKA and THA were approached jointly,29,30 and others wherein only TKA was considered,31–40 with only two studies41,42 focusing specifically on THA, thus leaving a considerable gap of knowledge in this field.…”

Section: Introductionmentioning

confidence: 99%

A comparison of predictors and intensity of acute postsurgical pain in patients undergoing total hip and knee arthroplasty

Pinto¹,

McIntyre²,

Araújo‐Soares³

et al. 2017

JPR

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Background: Acute pain is an expected result after surgery. Nevertheless, when not appropriately controlled, acute pain has a very negative impact on individual clinical outcomes, impairing healing and recovery, and has clear consequences on health care system costs. Augmenting knowledge on predictors and potentially modifiable determinants of acute postsurgical pain can facilitate early identification of and intervention in patients at risk. However, only a few studies have examined and compared acute pain after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The aim of this study was to compare THA and TKA in acute postsurgical pain intensity and its predictors. Methods: A consecutive sample of 124 patients with osteoarthritis (64 undergoing THA and 60 TKA) was assessed 24 hours before (T1) and 48 hours after (T2) surgery. Demographic, clinical, and psychological factors were assessed at T1, and acute postsurgical pain experience was examined at T2. Additionally, the same hierarchical regression analysis was performed separately for each arthroplasty type. Results: TKA patients reported higher levels of acute postsurgical pain compared with THA (t=8. 490, p=0.004, d=0.527, 95% confidence interval, 0.196-0.878). In the final THA predictive model, presurgical pain was the only variable approaching significant results (t[57]=1. 746, β=0.254, p=0.086). In the final TKA predictive model, optimism was the only predictor of pain (t[51]=-2.518, β=-0.339, p=0.015), with emotional representation (t[51]=1.895, β=0.254, p=0.064) presenting a trend toward significance. Conclusion: The current study is the first examining THA and TKA differences on acute postsurgical pain intensity and its predictors using a multivariate approach. Results from this study could prove useful for the design of distinct interventions targeting acute postsurgical pain management depending on whether the site of arthroplasty is the hip or the knee. Finally, the current results also support the argument that these two surgeries, at least with regard to acute pain, should be approached separately.

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The Influence of Chronic Pain on Postoperative Pain and Function After Hip Surgery: A Prospective Observational Cohort Study

Cited by 28 publications

References 46 publications

Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

Comparison between local infiltration analgesia with combined femoral and sciatic nerve block for pain management after total knee arthroplasty

A comparison of predictors and intensity of acute postsurgical pain in patients undergoing total hip and knee arthroplasty

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The Influence of Chronic Pain on Postoperative Pain and Function After Hip Surgery: A Prospective Observational Cohort Study

Cited by 28 publications

References 46 publications

Clinical relevance of persistent postoperative pain after total hip replacement &ndash; a prospective observational cohort study

Clinical relevance of persistent postoperative pain after total hip replacement &ndash; a prospective observational cohort study

Comparison between local infiltration analgesia with combined femoral and sciatic nerve block for pain management after total knee arthroplasty

A comparison of predictors and intensity of acute postsurgical pain in patients undergoing total hip and knee arthroplasty

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Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study