Motifi Fard Mehdi, Jazaiery Seyyed Mahdi, Ghaderi Milad, Ravanbod Hadi, Taravati Amir Mohammad, Rostami Koushan, Shahrokh Seyedeh Ghazal
Department of Orthopedic Surgery, Kashani University Hospital School of Medicine, Isfahan, Iran.
Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2024 Jul 29;13:59. doi: 10.4103/abr.abr_339_23. eCollection 2024.
Total knee arthroplasty (TKA) is one of the most common surgeries performed to reduce pain and disability in knee arthritis. Comprehension of the etiology and prevalence of persistent postoperative knee pain can help reduce this pain and identify the predictive factors leading to it. This study aimed to investigate the predictive factors and the prevalence of persistent pain after total knee arthroplasty in one-year follow-up.
This was a prospective cohort study. Demographic data including age, sex, body mass index (BMI), hospital anxiety and depression scale (HADS), and comorbidities were collected. In 242 patients, preoperative and postoperative Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were measured before and immediately after surgery and in 3-, 6-, and 12-month intervals during follow-up. Loosening of the prosthesis was also investigated by radiographic imaging in every postoperative visit.
WOMAC pain decreased from a mean (standard deviation) of 49 before surgery to 18 at 6 months and 13 at 12 months. Despite this, the prevalence of moderate-to-severe persistent postoperative pain (PPP) was 13.22% ( = 32) and 9.09% ( = 22) at 6 and 12 months lower preoperative WOMAC (odd's ratio:2.8), loosening of the prosthesis (odd's ratio:1.9), higher HADS (odd's ratio:2.1) were main predictors for PPP in TKA patients as in rheumatoid arthritis (odd's ratio:1.2).
Loosening of the prosthesis and higher preoperative WOMAC scores are key factors in persistent post-TKA pain. Depression and anxiety are more popular among patients with more pain after TKA. RA is more prevalent in patients with PPP after TKA.
全膝关节置换术（TKA）是为减轻膝关节炎疼痛和残疾而进行的最常见手术之一。了解术后持续性膝关节疼痛的病因和患病率有助于减轻这种疼痛并识别导致疼痛的预测因素。本研究旨在调查全膝关节置换术后一年随访中持续性疼痛的预测因素和患病率。
这是一项前瞻性队列研究。收集了包括年龄、性别、体重指数（BMI）、医院焦虑抑郁量表（HADS）和合并症在内的人口统计学数据。在242例患者中，术前和术后分别测量了西安大略和麦克马斯特大学关节炎指数（WOMAC）评分，术后立即测量，随访期间每3个月、6个月和12个月测量一次。每次术后随访还通过影像学检查假体松动情况。
WOMAC疼痛评分从术前平均（标准差）49降至术后6个月的18和12个月的13。尽管如此，6个月和12个月时中重度术后持续性疼痛（PPP）的患病率分别为13.22%（n = 32）和9.09%（n =
22）。术前较低的WOMAC评分（比值比：2.8）、假体松动（比值比：1.9）、较高的HADS评分（比值比：2.1）是TKA患者PPP的主要预测因素，类风湿关节炎患者中也是如此（比值比：1.2）。
假体松动和术前较高的WOMAC评分是TKA术后持续性疼痛的关键因素。抑郁和焦虑在TKA术后疼痛较多的患者中更为常见。RA在TKA术后PPP患者中更为普遍。
