Preoperative glycaemic control, number of pain locations, structural knee damage, self-reported central sensitisation, satisfaction and personal control are predictive of 1-year postoperative pain, and change in pain from pre- to 1-year posttotal knee arthroplasty.

IF 3.3 2区 医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-01-01 Epub Date: 2024-05-15 DOI:10.1002/ksa.12265
Sophie Vervullens, Lotte Meert, Rob J E M Smeets, Jonas Verbrugghe, Isabel Baert, Frank Th G Rahusen, Christiaan H W Heusdens, Peter Verdonk, Mira Meeus
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引用次数: 0

Abstract

Purpose: The aim of this study was to identify preoperative predictors for 1-year posttotal knee arthroplasty (TKA) pain and pre- to post-TKA pain difference in knee osteoarthritis (KOA) patients.

Methods: From March 2018 to July 2023, this prospective longitudinal cohort study enrolled KOA patients awaiting TKA from four hospitals in Belgium and the Netherlands. Different biopsychosocial predictors were assessed preoperatively by questionnaires and physical examinations (input variables). The Knee injury and Osteoarthritis Outcome Score (KOOS) subscale pain was used to measure pain intensity. The absolute KOOS subscale pain score 1-year post-TKA and the difference score (ΔKOOS = 1-year postoperative - preoperative) were used as primary outcome measures (output variables). Two multivariable linear regression analyses were performed.

Results: Two hundred and twenty-three participants were included after multiple imputation. Worse absolute KOOS subscale pain scores 1-year post-TKA and negative or closer to zero ΔKOOS subscale pain scores were predicted by self-reported central sensitisation, lower KOA grade and preoperative satisfaction, and higher glycated haemoglobin, number of pain locations and personal control (adjusted R2 = 0.25). Additional predictors of negative or closer to zero ΔKOOS subscale pain scores were being self-employed, higher preoperative pain and function (adjusted R2 = 0.37).

Conclusion: This study reports different biopsychosocial predictors for both outcomes that have filtered out other potential predictors and provide value for future studies on developing risk assessment tools for the prediction of chronic TKA pain.

Protocol registration: The protocol is registered at clinicaltrials.gov (NCT05380648) on 13 May 2022.

Level of evidence: Level II.

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术前血糖控制、疼痛部位数量、膝关节结构性损伤、自我报告的中枢敏感性、满意度和个人控制力可预测术后 1 年的疼痛以及全膝关节置换术后 1 年疼痛的变化。
目的:本研究旨在确定膝关节骨性关节炎(KOA)患者全膝关节置换术(TKA)术后1年疼痛的术前预测因素以及TKA术前与术后疼痛的差异:从2018年3月至2023年7月,这项前瞻性纵向队列研究从比利时和荷兰的四家医院招募了等待TKA的KOA患者。术前通过问卷调查和体格检查(输入变量)评估了不同的生物心理社会预测因素。膝关节损伤和骨关节炎结果评分(KOOS)疼痛分量表用于测量疼痛强度。膝关节置换术后 1 年的 KOOS 分量表疼痛绝对值和差异值(ΔKOOS = 术后 1 年 - 术前)作为主要结果测量指标(输出变量)。进行了两项多变量线性回归分析:结果:经过多重估算,共纳入 223 名参与者。TKA术后1年的KOOS分量表疼痛绝对评分较差,ΔKOOS分量表疼痛评分为负或接近零,而自我报告的中枢敏感性、较低的KOA等级和术前满意度,以及较高的糖化血红蛋白、疼痛部位数量和个人控制能力(调整后R2 = 0.25)都是预测因素。自营职业、较高的术前疼痛和功能(调整后 R2 = 0.37)也是ΔKOOS 疼痛评分为负或接近零的其他预测因素:本研究报告了两种结果的不同生物心理社会预测因素,这些因素过滤了其他潜在的预测因素,为今后研究开发预测慢性 TKA 疼痛的风险评估工具提供了价值:该方案于 2022 年 5 月 13 日在 clinicaltrials.gov (NCT05380648) 上注册:证据等级:二级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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