The natural history of pain and neuropathic pain after knee replacement: a prospective cohort study of the point prevalence of pain and neuropathic pain to a minimum three-year follow-up

2.50
Hdl Handle:
http://hdl.handle.net/11287/593814
Title:
The natural history of pain and neuropathic pain after knee replacement: a prospective cohort study of the point prevalence of pain and neuropathic pain to a minimum three-year follow-up
Authors:
Phillips, Jonathan R.; Hopwood, Beverley; Arthur, C.; Stroud, R.; Toms, Andrew
Abstract:
A small proportion of patients have persistent pain after total knee replacement (TKR). The primary aim of this study was to record the prevalence of pain after TKR at specific intervals post-operatively and to ascertain the impact of neuropathic pain. The secondary aim was to establish any predictive factors that could be used to identify patients who were likely to have high levels of pain or neuropathic pain after TKR. A total of 96 patients were included in the study. Their mean age was 71 years (48 to 89); 54 (56%) were female. The mean follow-up was 46 months (39 to 51). Pre-operative demographic details were recorded including a Visual Analogue Score (VAS) for pain, the Hospital Anxiety and Depression score as well as the painDETECT score for neuropathic pain. Functional outcome was assessed using the Oxford Knee score. The mean pre-operative VAS was 5.8 (1 to 10); and it improved significantly at all time periods post-operatively (p < 0.001): (from 4.5 at day three to five (1 to 10), 3.2 at six weeks (0 to 9), 2.4 at three months (0 to 7), 2.0 at six months (0 to 9), 1.7 at nine months (0 to 9), 1.5 at one year (0 to 8) and 2.0 at mean 46 months (0 to 10)). There was a high correlation (r > 0.7; p < 0.001) between the mean VAS scores for pain and the mean painDETECT scores at three months, one year and three years post-operatively. There was no correlation between the pre-operative scores and any post-operative scores at any time point. We report the prevalence of pain and neuropathic pain at various intervals up to three years after TKR. Neuropathic pain is an underestimated problem in patients with pain after TKR. It peaks at between six weeks and three-months post-operatively. However, from these data we were unable to predict which patients are most likely to be affected.
Citation:
Bone Joint J. 2014 Sep;96-B(9):1227-33.
Publisher:
Bone Joint Journal
Journal:
The bone & joint journal
Issue Date:
1-Sep-2014
URI:
http://hdl.handle.net/11287/593814
DOI:
10.1302/0301-620X.96B9.33756
PubMed ID:
25183595
Additional Links:
http://bjj.boneandjoint.org.uk/cgi/pmidlookup?view=long&pmid=25183595
Type:
Journal Article; Clinical Trial
Language:
eng
ISSN:
2049-4408
Appears in Collections:
General Trauma & Orthopaedics; Exeter Knee Reconstruction Unit (EKRU); Anaesthetics; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorPhillips, Jonathan R.en
dc.contributor.authorHopwood, Beverleyen
dc.contributor.authorArthur, C.en
dc.contributor.authorStroud, R.en
dc.contributor.authorToms, Andrewen
dc.date.accessioned2016-01-19T12:35:16Zen
dc.date.available2016-01-19T12:35:16Zen
dc.date.issued2014-09-01en
dc.identifier.citationBone Joint J. 2014 Sep;96-B(9):1227-33.en
dc.identifier.issn2049-4408en
dc.identifier.pmid25183595en
dc.identifier.doi10.1302/0301-620X.96B9.33756en
dc.identifier.urihttp://hdl.handle.net/11287/593814en
dc.description.abstractA small proportion of patients have persistent pain after total knee replacement (TKR). The primary aim of this study was to record the prevalence of pain after TKR at specific intervals post-operatively and to ascertain the impact of neuropathic pain. The secondary aim was to establish any predictive factors that could be used to identify patients who were likely to have high levels of pain or neuropathic pain after TKR. A total of 96 patients were included in the study. Their mean age was 71 years (48 to 89); 54 (56%) were female. The mean follow-up was 46 months (39 to 51). Pre-operative demographic details were recorded including a Visual Analogue Score (VAS) for pain, the Hospital Anxiety and Depression score as well as the painDETECT score for neuropathic pain. Functional outcome was assessed using the Oxford Knee score. The mean pre-operative VAS was 5.8 (1 to 10); and it improved significantly at all time periods post-operatively (p < 0.001): (from 4.5 at day three to five (1 to 10), 3.2 at six weeks (0 to 9), 2.4 at three months (0 to 7), 2.0 at six months (0 to 9), 1.7 at nine months (0 to 9), 1.5 at one year (0 to 8) and 2.0 at mean 46 months (0 to 10)). There was a high correlation (r > 0.7; p < 0.001) between the mean VAS scores for pain and the mean painDETECT scores at three months, one year and three years post-operatively. There was no correlation between the pre-operative scores and any post-operative scores at any time point. We report the prevalence of pain and neuropathic pain at various intervals up to three years after TKR. Neuropathic pain is an underestimated problem in patients with pain after TKR. It peaks at between six weeks and three-months post-operatively. However, from these data we were unable to predict which patients are most likely to be affected.en
dc.language.isoengen
dc.publisherBone Joint Journalen
dc.relation.urlhttp://bjj.boneandjoint.org.uk/cgi/pmidlookup?view=long&pmid=25183595en
dc.titleThe natural history of pain and neuropathic pain after knee replacement: a prospective cohort study of the point prevalence of pain and neuropathic pain to a minimum three-year follow-upen
dc.typeJournal Articleen
dc.typeClinical Trialen
dc.identifier.journalThe bone & joint journalen
All Items in RD&E Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.