Tanzer Michael, Laverdiere Carl, Elmasry Wassim, Hart Adam
Division of Orthopaedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
Jo Miller Orthopaedic Research Laboratory, McGill University Health Centre, Montreal, QC H3G 1A4, Canada.
Life (Basel). 2025 May 24;15(6):847. doi: 10.3390/life15060847.
While many patients report that their symptoms are influenced by weather conditions prior to their knee arthroplasty (TKA), how weather-related pain (WRP) evolves following surgery remains poorly understood. This study investigated the prevalence of WRP prior to and after TKA, assessed whether TKA resolves preoperative WRP, evaluated the incidence of new-onset WRP postoperatively, and identified associated risk factors.
We prospectively surveyed 87 patients (121 TKAs) at a mean follow-up of 9 years (range: 1-26 years). Patients completed a standardized questionnaire assessing WRP before and after surgery, along with patient-reported outcome measures (WOMAC, UCLA activity score, and SF-12). Statistical analysis was performed to assess the associations between WRP and clinical or demographic variables, as well as patient-reported outcome measures (PROMs) in patients with and without WRP.
Preoperatively, 31% of patients (37/121 knees) reported WRP. Following TKA, WRP resolved in 48% of these cases (18/37 knees), persisted in 16% (19/121 knees), and developed de novo in 16% of patients (20 knees). Postoperative WRP was significantly associated with the presence of WRP in other joints ( < 0.0001), and with female sex ( < 0.0008). Preoperatively, patients with WRP had worse WOMAC scores for pain ( = 0.046), stiffness ( = 0.012), and physical function ( = 0.024). Despite these differences, all groups demonstrated significant improvement in PROMs postoperatively, with no differences between groups at final follow-up ( > 0.125).
TKA leads to the resolution of WRP in nearly half of affected patients; however, a subset develops new or persistent WRP. Female sex, and multi-joint involvement are associated with WRP after TKA. These findings underscore the importance of preoperative counseling regarding expectations for pain relief, particularly in relation to weather sensitivity.
虽然许多患者报告称，在进行膝关节置换术（TKA）之前，他们的症状会受到天气状况的影响，但术后与天气相关的疼痛（WRP）如何演变仍知之甚少。本研究调查了TKA术前和术后WRP的患病率，评估了TKA是否能缓解术前WRP，评估了术后新发WRP的发生率，并确定了相关风险因素。
我们前瞻性地调查了87例患者（121例TKA），平均随访9年（范围：1 - 26年）。患者完成了一份标准化问卷，评估手术前后的WRP，以及患者报告的结局指标（WOMAC、加州大学洛杉矶分校活动评分和SF - 12）。进行统计分析以评估WRP与临床或人口统计学变量之间的关联，以及有和没有WRP的患者的患者报告结局指标（PROMs）。
术前，31%的患者（37/121膝）报告有WRP。TKA术后，这些病例中有48%（18/37膝）的WRP得到缓解，16%（19/121膝）持续存在，16%的患者（20膝）新发WRP。术后WRP与其他关节存在WRP显著相关（<0.0001），与女性性别相关（<0.0008）。术前，有WRP的患者在疼痛（=0.046）、僵硬（=0.012）和身体功能（=0.024）方面的WOMAC评分更差。尽管存在这些差异，但所有组在术后PROMs方面均有显著改善，最终随访时各组之间无差异（>0.125）。
TKA可使近一半受影响患者的WRP得到缓解；然而，一部分患者会出现新的或持续的WRP。女性性别和多关节受累与TKA术后的WRP相关。这些发现强调了术前关于疼痛缓解期望的咨询的重要性，特别是与天气敏感性相关的方面。
