Andrew

Arendt-Nielsen

Beswick

Felson

Finan

Finocchietti

Graven-Nielsen

Harden

Hawker

Hübscher

Jinks

Julien

Kellgren

Kosek

Kurtz

Lluch

Manafi-Khanian

Olesen

Perrot

Petersen

Phillips

Polianskis

Price

Rathleff

Sandrini

Siebuhr

Skou

Suokas

Vierck

Vægter

Weissman-Fogel

Wilder-Smith

Wylde

Yarnitsky

Chronic postoperative pain after total knee replacement (TKR) in knee osteoarthritis (KOA) implies clinical challenges. Widespread hyperalgesia, facilitated temporal summation of pain (TSP), and impaired conditioned pain modulation (CPM) have been found in painful KOA. This exploratory study investigated postoperative pain relief 12 months after TKR in 4 subgroups of patients preoperatively profiled by mechanistic quantitative sensory testing. In 103 patients with KOA, pressure pain detection threshold (PDT) and tolerance thresholds (PTT) were assessed at the lower leg using cuff algometry. Temporal summation of pain was measured as an increase in pain intensity scores during 10 repeated (2 seconds intervals) painful cuff stimuli. Conditioned pain modulation was calculated as the relative increase in PDT during painful conditioning stimulation. The grand averages of TSP and CPM were calculated and values below or above were used for subgrouping: facilitated TSP/impaired CPM (group A, N = 16), facilitated TSP/normal CPM (group B, N = 15), normal TSP/impaired CPM (group C, N = 44), and normal TSP/normal CPM (group D, N = 28). Clinical VAS pain intensity scores were collected before and 12 months after TKR surgery and the pain relief calculated. Less pain relief was found in group A (52.0% ± 14.0% pain relief) than in group B (81.1% ± 3.5%, P = 0.023) and group C (79.6% ± 4.4%, P = 0.007), but not group D (69.4% ± 7.9%, P = 0.087). Low preoperative PDT was associated with a less postoperative pain relief (R = -0.222, P = 0.034), whereas TSP or CPM alone showed no associations with postoperative pain relief. This explorative study indicated that patients with osteoarthritis with facilitated TSP together with impaired CPM are more vulnerable to experience less pain relief after TKR.</p

Petersen, Kristian Kjær

Graven-Nielsen, Thomas

Simonsen, Ole

Laursen, Mogens Berg

Arendt-Nielsen, Lars

VBN (Videnbasen)  Aalborg Universitets forskningsportal

Preoperative pain mechanisms assessed by cuff algometry are associated with chronic postoperative pain relief after total knee replacement

Kristian Kjær Petersen

Thomas Graven-Nielsen

Ole Simonsen

Mogens Berg Laursen

Lars Arendt-Nielsen

Crossref

Pain

http://vbn.aau.dk/ws/files/240654602/preoperative_pain_mechanisms_assessed_by_cuff_algometry_are_associated_with_chronic_postoperative_pain_relief_after_total_knee_replacement.pdf

Preoperative pain mechanisms assessed by cuff algometry are associated with chronic postoperative pain relief after total knee replacement

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VBN (Videnbasen) Aalborg Universitets forskningsportal

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