Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil Ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):782-790. doi: 10.1007/s00167-021-06455-5. Epub 2021 Jan 24.
The purpose of this study was to discover whether increased pain sensitivity was associated with postoperative pain and patient-reported outcome measures (PROMs) after total knee arthroplasty (TKA).
Pain sensitivity was evaluated preoperatively using a pain sensitivity questionnaire (PSQ). Resting, walking, nighttime, and average pain visual analog scale (VAS) were measured before surgery and 6 weeks, 3 months, 6 months, and 1 year after surgery. PROMs were also evaluated based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and patient satisfaction. The association between pain VAS average score, WOMAC total score, and PSQ score (minor, moderate, and total score) was assessed at each stage.
There were 59 patients with a high PSQ score (≥ 5.2) and 53 with a low PSQ score (< 5.2). Up to 1 year postoperatively, the group with high PSQ scores had higher resting, walking, nighttime, and average pain VAS scores than the group with low scores (all p < 0.05). Worse preoperative WOMAC pain, function, and total scores continued until 1 year after surgery in the high-scoring PSQ group (all p < 0.05). The group with low PSQ scores was more satisfied with surgery than the group with high scores (p = 0.027). There was a positive correlation between preoperative PSQ score and pain VAS average score at all time points (all p < 0.05). A relationship between PSQ score and WOMAC total score was also observed (all p < 0.05).
Increased pain sensitivity is a factor related to higher postoperative pain levels and inferior PROMs in patients undergoing primary TKA.
Case-controlled study, III.
本研究旨在探讨术后疼痛和患者报告的结局测量（PROMs）是否与全膝关节置换术（TKA）后疼痛敏感性增加有关。
术前使用疼痛敏感性问卷（PSQ）评估疼痛敏感性。在术前以及术后 6 周、3 个月、6 个月和 1 年时，测量静息、行走、夜间和平均疼痛视觉模拟量表（VAS）。还根据西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评分和患者满意度评估 PROMs。在每个阶段评估疼痛 VAS 平均评分、WOMAC 总分和 PSQ 评分（轻度、中度和总分）之间的相关性。
共有 59 例 PSQ 评分较高（≥5.2），53 例 PSQ 评分较低（<5.2）。在术后 1 年内，PSQ 评分较高的组在静息、行走、夜间和平均疼痛 VAS 评分上均高于评分较低的组（均 p<0.05）。PSQ 评分较高的组在术前 WOMAC 疼痛、功能和总分更差，持续到术后 1 年（均 p<0.05）。PSQ 评分较低的组对手术的满意度高于评分较高的组（p=0.027）。术前 PSQ 评分与所有时间点的疼痛 VAS 平均评分呈正相关（均 p<0.05）。PSQ 评分与 WOMAC 总分之间也存在相关性（均 p<0.05）。
疼痛敏感性增加是与初次 TKA 后更高的术后疼痛水平和较差的 PROMs 相关的因素。
病例对照研究，III 级。
