Evolución del dolor en pacientes con sensibilización central y artrosis tras artroplastia de rodilla

Casado-Adam, Pablo; Jiménez-Vílchez, Antonio José; Guler-Caamaño, Ipek; Cuevas-Pérez, Antonio; Quevedo-Reinoso, Rafael; Mayordomo-Riera, Fernando Jesús

doi:10.1016/j.rh.2021.06.002

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…This indicates a possible relationship between symptom severity and sensitization, independent of radiographic severity, and supports the concept that peripheral pathology is not the only cause of painful symptoms in knee OA [21,38]. Accordingly, central sensitization may also explain persistent pain following arthroplasty [40].…”

Section: Discussionsupporting

confidence: 80%

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Functional ability in knee osteoarthritis: role of neuropathic pain and central sensitization

Elsehrawy

Ibrahim

El-Shaarawy

et al. 2023

Egypt Rheumatol Rehabil

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Background Pain in osteoarthritis (OA) has been attributed traditionally to local tissue injury causing ‘nociceptive pain’. However, recent studies suggest that neuropathic and central sensitization mechanisms may contribute to the pain experience. However, the relationship between these pain mechanisms and physical function has not been thoroughly addressed. This study aimed to assess the association of central sensitization and neuropathic pain with physical function in knee OA. Results Participants with a positive central sensitization inventory score (CSI) (≥ 40) had a decreased total Knee injury and Osteoarthritis Outcome Score (KOOS) and its subscales (p < 0.001), a longer timed up and go test time (p = 0.002) and a higher PainDETECT questionnaire (PD-Q) and visual analogue scale (p < 0.001, p = 0.026 respectively). The severity of Kellgren-Lawrence grading (KL) (p < 0.001), depressive and anxiety symptoms (p < 0.001) increased with neuropathic pain severity. In addition, participants with a high PD-Q score (≥ 19) had a longer timed up and go test time (p < 0.001) and a decreased total KOOS score (p < 0.001). Moreover, we found that CSI score, KOOS score, and KL grading were significantly predicted the PD-Q score (p = 0.046, p < 0.001, p = 0.007, respectively). Regarding the physical function predictors, multivariate linear regression analysis revealed that pressure pain threshold at right elbow and right knee (p = 0.005, p < 0.001) in addition to PD-Q (P < 0.001) were significantly associated with KOOS score, while CSI and Hospital Anxiety Depression Scale were not. Conclusion Knee OA patients with significant central sensitization and neuropathic pain reported increased pain, more functional impairment, more anxiety and depressive symptoms than OA patients without central sensitization and neuropathic pain. Additionally, neuropathic pain and presence of central sensitization were significant predictors for functional ability.

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Section: Discussionsupporting

confidence: 80%

“…CSI scores range from 0-4, and are calculated to 100 points. There are five levels: subclinical (0-29), mild (30)(31)(32)(33)(34)(35)(36)(37)(38)(39), moderate (40)(41)(42)(43)(44)(45)(46)(47)(48)(49), severe (50-59), and extreme (60-100) [24].…”

Section: The Central Sensitization Inventory (Csi) [22]mentioning

confidence: 99%

Functional ability in knee osteoarthritis: role of neuropathic pain and central sensitization

Elsehrawy

Ibrahim

El-Shaarawy

et al. 2023

Egypt Rheumatol Rehabil

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“…In the current study, participants with knee OA and CS had greater self-perception functional impairment, confirming prior research showing that CSI scores correlated strongly with the WOMAC pain scores and moderately with the WOMAC function in patients undergoing total knee arthroplasty for knee OA [ 44 ]. In agreement, many patients with knee OA continued to experience CS after knee arthroplasty [ 45 ]. Moreover, these patients demonstrated a lower rate of minimal clinically important difference for the WOMAC score after total knee arthroplasty than patients without CS [ 46 ].…”

Section: Discussionmentioning

confidence: 85%

Neuropathic-like symptoms and central sensitization related signs and symptoms negatively affect the functional performance of patients with knee osteoarthritis – a cross-sectional study

Goldoni¹,

Bittencourt²,

Santo³

et al. 2023

Osteoarthritis and Cartilage Open

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Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study

et al. 2022

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ObjectiveAs part of the STAR Programme, a comprehensive study exploring long-term pain after surgery, we investigated how pain and function, health-related quality of life (HRQL), and healthcare resource use evolved over 5 years after total knee replacement (TKR) for those with and without chronic pain 1 year after their primary surgery.MethodsWe used data from the Clinical Outcomes in Arthroplasty Study prospective cohort study, which followed patients undergoing TKR from two English hospitals for 5 years. Chronic pain was defined using the Oxford Knee Score Pain Subscale (OKS-PS) where participants reporting a score of 14 or lower were classified as having chronic pain 1-year postsurgery. Pain and function were measured with the OKS, HRQL using the EuroQoL-5 Dimension, resource use from yearly questionnaires, and costs estimated from a healthcare system perspective. We analysed the changes in OKS-PS, HRQL and resource use over a 5-year follow-up period. Multiple imputation accounted for missing data.ResultsChronic pain was reported in 70/552 operated knees (12.7%) 1 year after surgery. The chronic pain group had worse pain, function and HRQL presurgery and postsurgery than the non-chronic pain group. Those without chronic pain markedly improved right after surgery, then plateaued. Those with chronic pain improved slowly but steadily. Participants with chronic pain reported greater healthcare resource use and costs than those without, especially 1 year after surgery, and mostly from hospital readmissions. 64.7% of those in chronic pain recovered during the following 4 years, while 30.9% fluctuated in and out of chronic pain.ConclusionAlthough TKR is often highly beneficial, some patients experienced chronic pain postsurgery. Although many fluctuated in their pain levels and most recovered over time, identifying people most likely to have chronic pain and supporting their recovery would benefit patients and healthcare systems.

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Evolución del dolor en pacientes con sensibilización central y artrosis tras artroplastia de rodilla

Cited by 3 publications

References 29 publications

Functional ability in knee osteoarthritis: role of neuropathic pain and central sensitization

Functional ability in knee osteoarthritis: role of neuropathic pain and central sensitization

Neuropathic-like symptoms and central sensitization related signs and symptoms negatively affect the functional performance of patients with knee osteoarthritis – a cross-sectional study

Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study

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