Pre-operative pressure pain thresholds do not meaningfully explain satisfaction or improvement in pain after knee replacement: a cohort study

Leung, Ying Ying; Lim, Zhui Ying; Fan, Qiao; Wylde, Vikki; Xiong, S.Q.; Yeo, Seng-Jin; Lo, Ngai-Nung; Chong, Hwei Chi; Yeo, William; Tan, Mann Hong; Chakraborty, Bibhas; Wong, SL; Thumboo, Julian

doi:10.1016/j.joca.2018.09.003

Cited by 13 publications

(11 citation statements)

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“…We also did not collect multiple measures that in the literature have been suggested to influence both baseline pain and post-surgical pain. For instance, measures of widespread hypersensitivity, temporal summation of pain and impaired endogenous pain inhibition assessed by quantitative sensory testing, have been suggested to contribute to poor pain relief following TKR [44,45], however see [46]. It was also previously shown that OA patients present central nervous system structural and functional maladaptive changes [47,48].…”

Section: Discussionmentioning

confidence: 99%

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

et al. 2020

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A significant proportion of osteoarthritis (OA) patients continue to experience moderate to severe pain after total joint replacement (TJR). Preoperative factors related to pain persistence are mainly studied using individual predictor variables and distinct pain outcomes, thus leading to a lack of consensus regarding the influence of preoperative parameters on post-TJR pain. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models and network analysis were applied to pain related biopsychosocial measures and their changes with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Although distinct pain scales were associated with different aspects of post-surgical pain, multi-factorial models did not reliably predict post-surgical pain in knee OA (across four distinct pain scales) and did not generalize to hip OA. However, network analysis showed significant changes in biopsychosocial-defined OA personality post-surgery, in both groups. Our results show that although tested clinical and biopsychosocial variables reorganize after TJR in OA, their presurgical values are not predictive of post-surgery pain. Derivation of prognostic markers for pain persistence after TJR will require more comprehensive understanding of underlying mechanisms.

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Section: Discussionmentioning

confidence: 99%

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

et al. 2020

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“…We also did not collect multiple measures that in the literature have been suggested to influence both baseline pain and post-surgical pain. For instance, measures of widespread hypersensitivity, temporal summation of pain and impaired endogenous pain inhibition assessed by quantitative sensory testing, have been suggested to contribute to poor pain relief following TKR [42, 43], however see [44]. It was also previously shown that OA patients present central nervous system structural and functional maladaptive changes [45, 46].…”

Section: Discussionmentioning

confidence: 99%

Prognostics for pain in osteoarthritis: Can clinical measures predict pain after total joint replacement?

Barroso

Wakaizumi

Reckziegel³

et al. 2019

Preprint

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A significant proportion of osteoarthritis (OA) patients continues to experience moderate to severe pain after total joint replacement (TJR). So far, preoperative factors related to pain persistence have been mainly studied using individual predictor variables and distinct pain outcomes, thus leading to lack of consensus in the field. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models were built, and a network analysis was applied to pain related biopsychosocial measures and their change with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Distinct pain scales were associated with different aspects of the pain experience. Multi-factorial models did not reliably predict post-surgical pain in knee OA across four distinct pain scales and did not generalize to hip OA; however, network analysis of pain related biopsychosocial measures showed significant changes post-surgery in both groups. Our results show that although tested clinical and biopsychosocial variables are reorganizing after TJR in OA, they do not present as a robust markers for post-surgery pain outcomes. A better understanding of mechanisms underlying pain persistence after TJR is necessary to derive clinical prognostic factors.

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“…The study design and protocol of the original study have been published previously 21. In brief, patients listed for knee arthroplasty for clinician diagnosed KOA were recruited 1–2 weeks prior to arthroplasty at pre-operative assessment visit.…”

Section: Methodsmentioning

confidence: 99%

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

Yeo

Wylde

et al. 2022

RMD Open

Self Cite

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ObjectivesWe aim to evaluate the effect on different ways of classifying pain sensitisation on impact and quality of life (QoL) in knee osteoarthritis (KOA).MethodsWe used baseline data from a cohort of consecutive patients with KOA listed for arthroplasty. We collected demographics and number of painful body sites. We measured pressure pain thresholds at the right forearm (PPTarm). Pain sensitisation was classified using: (1) widespread pain, (2) lowest 10th percentile of PPTarm and (3) PainDETECT questionnaire ≥13/38. Impact and QoL were assessed using Western Ontario and McMaster Universities Osteoarthritis Index and Short Form-36. Impact and QoL scores in patients with or without pain sensitisation were compared. We evaluated the association of pain sensitisation measures with QoL scores using multivariable regression.Results233 patients (80% female, mean age 66 years) included in the analysis; 7.3%, 11.6% and 4.7% were classified as having pain sensitisation by widespread pain, low PPTarm and PainDETECT criteria, respectively. There was minimal overlap of patients as classified as pain sensitisation phenotype by different measures. Patients with pain sensitisation had poorer QoL compared with those without. Low PPTarm identified patients with poorer general health, while widespread pain and PainDETECT identified poorer QoL in more psychological domains. There was weak correlation between number of painful body sites and PainDETECT (rho=0.23, p<0.01), but no significant correlation with PPTarm.ConclusionPatients with KOA with pain sensitisation have poorer QoL compared with those without, regardless of classification method. Different criteria defined patients with different pattern of QoL impact.

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Pre-operative pressure pain thresholds do not meaningfully explain satisfaction or improvement in pain after knee replacement: a cohort study

Cited by 13 publications

References 58 publications

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

Prognostics for pain in osteoarthritis: Can clinical measures predict pain after total joint replacement?

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

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