Nikolajsen L, Brandsborg B, Lucht U, Jensen T S, Kehlet H
Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
Acta Anaesthesiol Scand. 2006 Apr;50(4):495-500. doi: 10.1111/j.1399-6576.2006.00976.x.
Chronic post-operative pain is a well-recognized problem after various types of surgery, but little is known about chronic pain after orthopedic surgery. Severe pre-operative pain is the primary indication for total hip arthroplasty (THA). Therefore, we examined the prevalence of chronic pain after THA in relation to pre-operative pain and early post-operative pain.
A questionnaire was sent to 1231 consecutive patients who had undergone THA 12-18 months previously, and whose operations had been reported to the Danish Hip Arthroplasty Registry.
The response rate was 93.6%. Two hundred and ninety-four patients (28.1%) had chronic ipsilateral hip pain at the time of completion of the questionnaire, and pain limited daily activities to a moderate, severe or very severe degree in 12.1%. The chronic pain state was related to the recalled intensity of early post-operative pain [95% confidence interval (CI), 20.4-33.4%] and pain complaints from other sites of the body (95% CI, 20.7-32.1%), but not to the pre-operative intensity of pain.
Chronic pain after THA seems to be a significant problem in at least 12.1% of patients. Our results suggest that genetic and psychosocial factors are important for the development of chronic post-THA pain.
慢性术后疼痛是各类手术后一个广为人知的问题，但对于骨科手术后的慢性疼痛却知之甚少。严重的术前疼痛是全髋关节置换术（THA）的主要指征。因此，我们研究了全髋关节置换术后慢性疼痛的发生率与术前疼痛及术后早期疼痛的关系。
向1231例12至18个月前接受全髋关节置换术且手术已上报至丹麦髋关节置换登记处的连续病例发放问卷。
应答率为93.6%。在完成问卷调查时，294例患者（28.1%）存在同侧髋关节慢性疼痛，其中12.1%的患者疼痛将日常活动限制在中度、重度或极重度程度。慢性疼痛状态与术后早期疼痛的回忆强度[95%置信区间（CI），20.4 - 33.4%]以及身体其他部位的疼痛主诉（95% CI，20.7 - 32.1%）相关，但与术前疼痛强度无关。
全髋关节置换术后慢性疼痛似乎在至少12.1%的患者中是一个重要问题。我们的结果表明，遗传和心理社会因素对于全髋关节置换术后慢性疼痛的发生发展很重要。
