Long-Lasting Hyperalgesia Is Common in Patients Following Patella Fractures

“…For evaluating mechanical hyperalgesia of the knee, the patellar tendon was representatively selected because of easy palpation, high reproducibility, and less effect of pain due to patellofemoral osteoarthritis. 16 Pressure was applied at a rate of 30 kPa/s until patients experienced pain. PPT was measured five times at 20-second intervals.…”

Section: Assessmentmentioning

confidence: 99%

Comparison of Predisposing Factors Between Pain on Walking and Pain at Rest in Patients with Knee Osteoarthritis

Satake¹,

Izumi²,

Aso³

et al. 2021

JPR

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Purpose: Patients with knee osteoarthritis (OA) complain of various types of pain, divided into two main categories: pain on movement and pain at rest. A thorough understanding of pain is essential for managing knee OA; however, few studies have investigated the mechanisms underlying the two different types of pain. This study aimed to clarify the predisposing factors for pain in patients with knee OA with a focus on differences between pain on walking and pain at rest. Patients and Methods: This study involved 93 patients, aged 44-90 years, with knee OA, including 74 women. We assessed demographic variables (sex, age, body mass index [BMI], side), visual analogue scale (VAS) score on walking, VAS score at rest, Kellgren and Lawrence (KL) grade on radiograph, synovitis score and bone marrow lesion (BML) score on magnetic resonance imaging, and pressure pain threshold (PPT), and used univariate and multiple regression analyses to investigate factors predisposing patients to pain at rest or pain on walking. Results: In the univariate analyses, we found significant correlations between VAS score on walking and BMI (r=0.31, p<0.01), KL grade (r=0.40, p<0.01), synovitis score (r=0.26, p=0.01), and BML score (r=0.36, p<0.01), whereas VAS score at rest correlated with PPT (r=−0.23, p=0.02) and BMI (r= 0.26, p=0.01). Multiple regression analysis showed that significant explanatory factors for VAS score on walking were BMI (β=0.22, p=0.03) and KL grade (β=0.27, p=0.03). By contrast, PPT was the only significant explanatory factor for VAS score at rest (β=−0.27, p=0.01). Conclusion:Predisposing factors were significantly different between pain on walking and pain at rest, indicating that different pain mechanisms exist in the two types of pain. Pain on walking was more strongly associated with mechanical and structural factors, while pain at rest was associated with mechanical hyperalgesia of the knee.

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“…Following patella fractures, patients commonly report pain, restrictions in range of joint motion, muscle weakness, difficulties with weight-bearing tasks such as walking and climbing stairs, and restrictions in quality of life. [5][6][7][8][9]. Furthermore, outcomes following patella fractures were reported with high rates of complications and re-operations [10] and increased risk of development of post-traumatic knee osteoarthrosis [11].…”

mentioning

confidence: 99%

Tension band versus locking plate fixation for patella fractures – a protocol of a randomised controlled trial

Elsoe,

Thorninger,

Severinsen

et al. 2024

Dan Med J

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INTRODUCTION. Following surgical management of patella fractures, patients commonly report pain; difficulties with weight-bearing tasks such as walking, running and climbing stairs; and restrictions in quality of life. Recently, a locking plate system for surgical management of patella fractures has been introduced. To date, no studies have compared standard treatment with tension band wiring with locking plate fixation in a randomised study design. We aim to compare the one-year patient-reported Knee Injury and Osteoarthritis Outcome subscale scores (KOOS5-subscales) after standard care tension band fixation with locking plate fixation for patients with patella fractures. METHODS. This is a multicentre randomised and prospective clinical trial. A total of 122 patients will be included in the study, and the primary outcome will be the KOOS subscales at 12 months after surgery. CONCLUSIONS. Findings from the present study are expected to advance our understanding of outcome following surgical treatment of patella fractures. FUNDING. This study is funded, in part, by the Novo Nordisk Foundation, Denmark. TRIAL REGISTRATION. ClinicalTrials.gov ID: NCT04891549

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Long-Lasting Hyperalgesia Is Common in Patients Following Patella Fractures

Abstract: The present study suggests that long-lasting local hyperalgesia following a patella fracture is common. No side-to-side difference at the forearms were observed, indicating that the observed local hyperalgesia was not part of a generalized sensitization.

Cited by 7 publications

References 24 publications

Arthroscopically Assisted, Minimally Invasive Percutaneous Fixation of a Patellar Fracture

Arthroscopically Assisted, Minimally Invasive Percutaneous Fixation of a Patellar Fracture

Comparison of Predisposing Factors Between Pain on Walking and Pain at Rest in Patients with Knee Osteoarthritis

Tension band versus locking plate fixation for patella fractures – a protocol of a randomised controlled trial

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