Risk Factors of Neuropathic Pain after Total Hip Arthroplasty

Abstract

PurposePain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire.Materials and MethodsOne hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA.ResultsThe patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA.ConclusionTHA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

Mechanism of Chronic Pain of Symptomatic Hip Osteoarthritis by Association of its Distribution, Nociceptive, Neuropathic, Nociplastic, or Mixed-pain Screening, and the Prevalence of Lumbar Spinal Stenosis

“…Neuropathic pain contributes to the pain of hip OA, as found in clinical and basic research 8,13,19,24,25,51,52. The frequency of neuropathic pain in patients with OA of the hip according to prior clinical studies using PDQ or modified PDQ were: likely neuropathic pain, 5.9% to 15.8%; and possible neuropathic pain, 12.6% to 36.8% 13,19,52,53.…”

“…Neuropathic pain contributes to the pain of hip OA, as found in clinical and basic research. 8,13,19,24,25,51,52 The frequency of neuropathic pain in patients with OA of the hip according to prior clinical studies using PDQ or modified PDQ were: likely neuropathic pain, 5.9% to 15.8%; and possible neuropathic pain, 12.6% to 36.8%. 13,19,52,53 Recently, nociplastic pain was defined as a third mechanistic pain descriptor for chronic pain states, and chronic primary musculoskeletal pain was distinguished as a category of nociplastic pain syndrome.…”

Evaluation of disease burden, patient journey, unmet diagnosis and treatment needs of patients with HIP and knee osteoarthritis in Turkey: A study through Delphi Methodology

“…Current treatments, including arthroplasty, were not deemed to be sufficient by the panelists to meet the therapeutic needs of patients with moderate-to-severe OA. Joint replacement proves to be an effective treatment option for advanced-stage hip and knee OA and relieves pain in the majority of patients; however, 10–40% continue to experience moderate-to-severe persistent pain after surgery, and joint replacements tend to wear out after a certain amount of time [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Individualized multidisciplinary analgesia to prevent persistent postsurgical pain

“…Preoperative signs of neuropathic pain were correlated with neuropathic symptoms postoperatively. Interestingly there was NO correlation between neuropathic pain and the radiographic severity of arthrosis [52].…”