Maeda Kazumasa, Sonohata Motoki, Kitajima Masaru, Kawano Shunsuke, Mawatari Masaaki
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan.
Hip Pelvis. 2018 Dec;30(4):226-232. doi: 10.5371/hp.2018.30.4.226. Epub 2018 Dec 6.
Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire.
One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA.
The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA.
THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.
骨关节炎引起的疼痛主要是伤害感受性疼痛;然而,人们认为这种疼痛的一部分是由神经性疼痛(NP)引起的。我们研究了全髋关节置换术(THA)对通过疼痛检测问卷诊断为NP的患者的影响。
评估了163个髋关节(161例患者)。所有患者都被要求根据他们的NP经历完成疼痛检测问卷,并在THA前后使用日本骨科协会(JOA)髋关节评分评估临床评分。
24.5%的患者在THA前报告有NP;5.5%的患者在THA后2个月报告有NP。在THA之前,疼痛检测评分与影像学严重程度之间没有显著相关性;然而,疼痛检测评分与JOA评分之间存在显著相关性。THA后2个月的NP与THA后1周的疼痛评分没有显著相关性;然而,术前疼痛评分与THA后2个月的NP之间存在显著相关性。
THA有助于缓解髋骨关节炎患者的伤害感受性疼痛和NP。术前疼痛是THA后发生NP的一个危险因素。控制术前疼痛可能对减少术后NP有效。