Yıl: 2021 Cilt: 27 Sayı: 2 Sayfa Aralığı: 103 - 108 Metin Dili: İngilizce DOI: 10.4274/tod.galenos.2020.62533 İndeks Tarihi: 01-10-2021

Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients

Öz:
Objective: This study aimed to investigate the presence of neuropathic pain (NP) in female patients after total knee arthroplasty (TKA) alongwith NP-associated factors.Materials and Methods: In total, 85 female patients who underwent TKA due to knee osteoarthritis were included in this study. Sociodemographic factors along with medical and psychological comorbidities were investigated. Pain levels were assessed using the visualanalogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scales. The functional status wasassessed using the WOMAC physical function scales. Importantly, the presence of NP was assessed using the PainDETECT questionnaire. Theemotional status of the patients was assessed using the hospital anxiety depression scale.Results: In total, 9 (10.6%) patients were classified as having likely NP and 14 (16.5%) as having possible NP. The PainDETECT scoreswere significantly correlated with the preoperative VAS scores (p=0.004), WOMAC pain (p=0.000) and physical function scores (p=0.007)and presence of depression (p=0.021) Furthermore, the PainDETECT scores were significantly negatively correlated with the period afterarthroplasty (p=0.033). No correlation was found between NP and socio-demographic factors and medical comorbidities.Conclusion: Patients with NP had a shorter period after arthroplasty, depression, an increased severity of pain and a decreased physicalfunction. The presence of NP in the patients who underwent TKA should be considered and associated factors should be evaluated.
Anahtar Kelime:

Total Diz Artroplasti Sonrası Nöropatik Ağrı: Kadın Hastalarda Kesitsel Bir Çalışma

Öz:
Amaç: Çalışmanın amacı total diz protezinden (TKA) sonra nöropatik ağrı (NP) varlığını ve NP’nin sosyo-demografik faktörler, fiziksel fonksiyon, medikal ve psikolojik komorbiditeler ile ilişkisini araştırmaktır. Gereç ve Yöntem: Diz osteoartriti nedeni ile TKA olan 85 kadın hasta çalışmaya dahil edildi. Sosyo-demografik faktörler, medikal ve psikolojik komorbiditeler sorgulandı. Ağrı şiddeti görsel analog skala (VAS) ve Western Ontario ve McMaster Üniversiteleri Artrit İndeksi (WOMAC) ağrı skalası ile, fonksiyonel durum WOMAC fiziksel fonksiyon skalası ile, NP varlığı PainDETECT Ağrı anketi ile, hastaların emosyonel durumu hastane anksiyete depresyon skalası ile değerlendirildi. Bulgular: Dokuz hasta (%10,6) NP pozitif, 14 hasta (%16,5) muhtemel NP olarak sınıflandırıldı. PainDETECT skorları ile operasyon öncesi VAS skorları (p=0,004), WOMAC ağrı (p=0,000) ve fiziksel fonksiyon skorları (p=0,007) ve depresyon varlığı (p=0,021) arasında anlamlı pozitif korelasyon, artroplastiden sonra geçen zaman ile arasında negatif korelasyon (p=0.033) saptandı. NP ve sosyo-demografik faktörler ve medikal komorbiditeler arasında ilişki saptanmadı. Sonuç: Bu çalışmanın sonuçları TKA sonrası bazı hastalarda NP olduğunu gösterdi. NP’si olan hastaların artroplasti sonrası dönemin daha kısa olduğu ve bu hastaların depresyonu olduğu, ağrı ve disabilitesinin artmış olduğu saptandı. TKA hastalarında NP varlığı düşünülmeli ve ilişkili faktörler değerlendirilmelidir. TKA sonrası ağrı tedavisinde NP için uygun tedavi stratejileri dahil edilmelidir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Lewis GN, Rice DA, McNair PJ, Kluger M. Predictors of persistent pain after total knee arthroplasty: a systematic review and metaanalysis. Br J Anaesth 2015;114:551-61.
  • 2. Pinto PR, McIntyre T, Ferrero R, Almeida A, Araújo-Soares V. Risk factors for moderate and severe persistent pain in patients undergoing total knee and hip arthroplasty: a prospective predictive study. PLoS One 2013;8:e73917.
  • 3. Protzman NM, Gyi J, Malhotra AD, Kooch JE. Examining the feasibility of radiofrequency treatment for chronic knee pain after total knee arthroplasty. PM R 2014;6:373-6.
  • 4. Chughtai M, Elmallah RD, Mistry JB, Bhave A, Cherian JJ, McGinn TL, et al. Nonpharmacologic Pain Management and Muscle Strengthening following Total Knee Arthroplasty. J Knee Surg 2016;29:194-200.
  • 5. Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2012;2:e000435.
  • 6. Vergne-Salle P. Management of neuropathic pain after knee surgery. Joint Bone Spine 2016;83:657-63.
  • 7. Phillips JR, Hopwood B, Arthur C, Stroud R, Toms AD. 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. Bone Joint J 2014;96-B:1227-33.
  • 8. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006;367:1618-25.
  • 9. Haroutiunian S, Nikolajsen L, Finnerup NB, Jensen TS. The neuropathic component in persistent postsurgical pain: a systematic literature review. Pain 2013;154:95-102.
  • 10. Wright A, Moss P, Sloan K, Beaver RJ, Pedersen JB, Vehof G, et al. Abnormal quantitative sensory testing is associated with persistent pain one year after TKA. Clin Orthop Relat Res 2015;473:246-54.
  • 11. Drosos GI, Triantafilidou T, Ververidis A, Agelopoulou C, Vogiatzaki T, Kazakos K. Persistent post-surgical pain and neuropathic pain after total knee replacement. World J Orthop 2015;6:528-36.
  • 12. Fuzier R, Rousset J, Bataille B, Salces-y-Nédéo A, Maguès JP. One half of patients reports persistent pain three months after orthopaedic surgery. Anaesth Crit Care Pain Med 2015;34:159- 64.
  • 13. Singh JA, Lewallen DG. Medical and psychological comorbidity predicts poor pain outcomes after total knee arthroplasty. Rheumatology (Oxford) 2013;52:916-23.
  • 14. Albayrak I, Apiliogullari S, Erkocak OF, Kavalci H, Ozerbil OM, Levendoglu F. Total Knee Arthroplasty due to Knee Osteoarthritis: Risk Factors for Persistent Postsurgical Pain. J Natl Med Assoc 2016;108:236-43.
  • 15. Tok F, Aydemir K, Peker F, Safaz I, Taşkaynatan MA, Ozgül A. The effects of electrical stimulation combined with continuous passive motion versus isometric exercise on symptoms, functional capacity, quality of life and balance in knee osteoarthritis: randomized clinical trial. Rheumatol Int 2011;31:177-81.
  • 16. Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005;13:28-33.
  • 17. Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006;22:1911-20.
  • 18. Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med 2013;14:1933-43.
  • 19. Aydemir O, Guvenir T, Kuey L. Hastane anksiyete ve depresyon ölceği turkce formunun geçerlilik ve güvenilirlik çalışması. Turk Psikiyatri Dergisi 1997;8:280-7.
  • 20. Wylde V, Hewlett S, Learmonth ID, Dieppe P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain 2011;152:566-72.
  • 21. Pinto PR, McIntyre T, Ferrero R, Araújo-Soares V, Almeida A. Persistent pain after total knee or hip arthroplasty: differential study of prevalence, nature, and impact. J Pain Res 2013;6:691- 703.
  • 22. Razmjou H, Boljanovic D, Wright S, Murnaghan J, Holtby R. Association between Neuropathic Pain and Reported Disability after Total Knee Arthroplasty. Physiother Can 2015;67:311-8.
  • 23. Wylde V, Jeffery A, Dieppe P, Gooberman-Hill R. The assessment of persistent pain after joint replacement. Osteoarthritis Cartilage 2012;20:102-5.
  • 24. Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R, et al. Health-related quality of life after knee replacement. J Bone Joint Surg Am 1998;80:163-73.
  • 25. Singh JA, Gabriel SE, Lewallen DG. Higher body mass index is not associated with worse pain outcomes after primary or revision total knee arthroplasty. J Arthroplasty 2011;26:366-374.e1.
  • 26. Lavand’homme PM, Grosu I, France MN, Thienpont E. Pain trajectories identify patients at risk of persistent pain after knee arthroplasty: an observational study. Clin Orthop Relat Res 2014;472:1409-15.
  • 27. Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Healthrelated quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 2004;86:963-74.
  • 28. Brander V, Gondek S, Martin E, Stulberg SD. Pain and depression influence outcome 5 years after knee replacement surgery. Clin Orthop Relat Res 2007;464:21-6.
  • 29. Hanusch BC, O’Connor DB, Ions P, Scott A, Gregg PJ. Effects of psychological distress and perceptions of illness on recovery from total knee replacement. Bone Joint J 2014;96-B:210-6.
APA polat c, Sezgin Ozcan D, ALTAS E, Sahin Onat S, KOSEOGLU B (2021). Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. , 103 - 108. 10.4274/tod.galenos.2020.62533
Chicago polat cemile sevgi,Sezgin Ozcan Didem,ALTAS Elif Umay,Sahin Onat Sule,KOSEOGLU BELMA F?SUN Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. (2021): 103 - 108. 10.4274/tod.galenos.2020.62533
MLA polat cemile sevgi,Sezgin Ozcan Didem,ALTAS Elif Umay,Sahin Onat Sule,KOSEOGLU BELMA F?SUN Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. , 2021, ss.103 - 108. 10.4274/tod.galenos.2020.62533
AMA polat c,Sezgin Ozcan D,ALTAS E,Sahin Onat S,KOSEOGLU B Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. . 2021; 103 - 108. 10.4274/tod.galenos.2020.62533
Vancouver polat c,Sezgin Ozcan D,ALTAS E,Sahin Onat S,KOSEOGLU B Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. . 2021; 103 - 108. 10.4274/tod.galenos.2020.62533
IEEE polat c,Sezgin Ozcan D,ALTAS E,Sahin Onat S,KOSEOGLU B "Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients." , ss.103 - 108, 2021. 10.4274/tod.galenos.2020.62533
ISNAD polat, cemile sevgi vd. "Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients". (2021), 103-108. https://doi.org/10.4274/tod.galenos.2020.62533
APA polat c, Sezgin Ozcan D, ALTAS E, Sahin Onat S, KOSEOGLU B (2021). Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. Türk Osteoporoz Dergisi, 27(2), 103 - 108. 10.4274/tod.galenos.2020.62533
Chicago polat cemile sevgi,Sezgin Ozcan Didem,ALTAS Elif Umay,Sahin Onat Sule,KOSEOGLU BELMA F?SUN Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. Türk Osteoporoz Dergisi 27, no.2 (2021): 103 - 108. 10.4274/tod.galenos.2020.62533
MLA polat cemile sevgi,Sezgin Ozcan Didem,ALTAS Elif Umay,Sahin Onat Sule,KOSEOGLU BELMA F?SUN Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. Türk Osteoporoz Dergisi, vol.27, no.2, 2021, ss.103 - 108. 10.4274/tod.galenos.2020.62533
AMA polat c,Sezgin Ozcan D,ALTAS E,Sahin Onat S,KOSEOGLU B Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. Türk Osteoporoz Dergisi. 2021; 27(2): 103 - 108. 10.4274/tod.galenos.2020.62533
Vancouver polat c,Sezgin Ozcan D,ALTAS E,Sahin Onat S,KOSEOGLU B Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients. Türk Osteoporoz Dergisi. 2021; 27(2): 103 - 108. 10.4274/tod.galenos.2020.62533
IEEE polat c,Sezgin Ozcan D,ALTAS E,Sahin Onat S,KOSEOGLU B "Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients." Türk Osteoporoz Dergisi, 27, ss.103 - 108, 2021. 10.4274/tod.galenos.2020.62533
ISNAD polat, cemile sevgi vd. "Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients". Türk Osteoporoz Dergisi 27/2 (2021), 103-108. https://doi.org/10.4274/tod.galenos.2020.62533