Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Arch Orthop Trauma Surg. 2023 Apr;143(4):2189-2197. doi: 10.1007/s00402-022-04445-x. Epub 2022 May 5.
Chronic pain of various origin is known to be associated with selective cognitive impairment. Osteoarthritis (OA) of the hip is one of the leading causes of chronic pain in the adult population, but its association with cognitive performance has not been evaluated. Here, we investigate the effect of chronic pain due to unilateral OA of one hip and no further source of chronic pain on cognitive performance.
A neuropsychological test battery, consisting of the Mini-Mental State Examination, Rey-Osterrieth complex figure test, Rivermead behavioural memory test, d2 test of attention, and F-A-S test was applied in 148 patients and 82 healthy pain-free control individuals. The influence of potentially confounding factors such as depression and anxiety was examined.
Patients with OA of the hip showed decreased performance in specific neuropsychological tests. Performance in verbal and visual short-term and long-term memory and selective attention tests was significantly poorer compared to healthy controls. Whereas the executive functions "updating", "set shifting", "response inhibition" and "reflection" appear intact, "problem solving" and "planning" were impaired. None of the confounders showed any influence on cognitive performance in both study groups.
We conclude that chronic pain secondary to end-stage hip OA is associated with selective cognitive impairment. Future studies are required to investigate the effect of total hip arthroplasty on cognitive performance.
各种原因引起的慢性疼痛已知与选择性认知障碍有关。髋关节骨关节炎（OA）是成年人慢性疼痛的主要原因之一，但尚未评估其与认知表现的关系。在这里，我们研究了单侧髋关节 OA 引起的慢性疼痛而无其他慢性疼痛源对认知表现的影响。
神经心理学测试包包括简易精神状态检查、 Rey-Osterrieth 复杂图形测试、Rivermead 行为记忆测试、d2 注意力测试和 F-A-S 测试，应用于 148 名患者和 82 名健康无痛对照组个体。检查了抑郁和焦虑等潜在混杂因素的影响。
髋关节 OA 患者在特定神经心理学测试中表现下降。与健康对照组相比，言语和视觉短期和长期记忆以及选择性注意力测试的表现明显较差。而“更新”、“转换”、“反应抑制”和“反射”等执行功能似乎完好无损，“解决问题”和“规划”则受损。在两个研究组中，没有任何混杂因素对认知表现有任何影响。
我们得出结论，晚期髋关节 OA 引起的慢性疼痛与选择性认知障碍有关。需要进一步研究全髋关节置换术对认知表现的影响。
