Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2021 Oct 28

PMID 34707402

Citations 9

Authors

Yoshihisa Ohashi

Kensuke Fukushima

Kentaro Uchida

Tomohisa Koyama

Maho Tsuchiya

Hiroki Saito

Katsufumi Uchiyama

Naonobu Takahira

Gen Inoue

Masashi Takaso

Affiliations

Soon will be listed here.

Abstract

Background: In patients with hip osteoarthritis (OA), pain at rest, unlike pain on activity, is due to pain mechanisms that cannot be explained by nociceptive pain. However, it remains unclear whether central sensitization (CS) is one of the causes of exacerbated pain at rest in patients with hip OA. Therefore, we investigated the differences in causative factors and postoperative course of total hip arthroplasty (THA) between preoperative pain at rest and on activity in patients with hip OA.

Methods: In total, 120 patients (125 hips, 22 men and 98 women, aged 64.5±1.0 years) with hip OA were included. Preoperative pain at rest and on activity and CS were assessed using the visual analog scale (VAS) and CS Inventory (CSI), respectively. Postoperative assessments were evaluated using the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ); pain, satisfaction, function, and mental scores were evaluated 6 and 12 months after THA.

Results: Multivariate regression analysis indicated the CSI score as affecting VAS for pain at rest (β=0.067, P=0.002) but not VAS for pain on activity (β=0.036, P=0.073). VAS for pain at rest had a weak negative correlation with satisfaction and pain scores at both 6 and 12 months after THA (satisfaction, =-0.309, -0.278; pain, =-0.202, -0.22). VAS for pain on activity was not correlated with JHEQ. The CSI score had a weak or moderate negative correlation with three scores other than the function score at both 6 and 12 months after THA (satisfaction, =-0.266, -0.213; pain, =-0.332, -0.203, mental, =-0.427, -0.370). The function score was weakly correlated with the CSI score only 6 months after THA (function, =-0.231, -0.190).

Conclusion: A higher level of preoperative pain at rest, a CS-related symptom, may affect postoperative pain persistence and dissatisfaction in patients with hip OA.

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References

Enomoto H, Fujikoshi S, Tsuji T, Sasaki N, Tokuoka H, Uchio Y . Efficacy of duloxetine by prior NSAID use in the treatment of chronic osteoarthritis knee pain: A post hoc subgroup analysis of a randomized, placebo-controlled, phase 3 study in Japan. J Orthop Sci. 2018; 23(6):1019-1026. DOI: 10.1016/j.jos.2018.07.008. View

Kim S, Yoon K, Yoon D, Yoo J, Ahn K . Influence of Centrally Mediated Symptoms on Postoperative Pain in Osteoarthritis Patients Undergoing Total Knee Arthroplasty: A Prospective Observational Evaluation. Pain Pract. 2015; 15(6):E46-53. DOI: 10.1111/papr.12311. View

Koh I, Kang B, Kim M, Choi K, Sohn S, In Y . How Does Preoperative Central Sensitization Affect Quality of Life Following Total Knee Arthroplasty?. J Arthroplasty. 2020; 35(8):2044-2049. DOI: 10.1016/j.arth.2020.04.004. View

Koh I, Kim M, Sohn S, Song K, Choi N, In Y . Duloxetine Reduces Pain and Improves Quality of Recovery Following Total Knee Arthroplasty in Centrally Sensitized Patients: A Prospective, Randomized Controlled Study. J Bone Joint Surg Am. 2019; 101(1):64-73. DOI: 10.2106/JBJS.18.00347. View

Seki T, Hasegawa Y, Ikeuchi K, Ishiguro N, Hiejima Y . Reliability and validity of the Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ) for patients with hip disease. J Orthop Sci. 2013; 18(5):782-7. DOI: 10.1007/s00776-013-0436-8. View

Woolf C . Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 2004; 140(6):441-51. DOI: 10.7326/0003-4819-140-8-200404200-00010. View

Kovalenko B, Bremjit P, Fernando N . Classifications in Brief: Tönnis Classification of Hip Osteoarthritis. Clin Orthop Relat Res. 2018; 476(8):1680-1684. PMC: 6259761. DOI: 10.1097/01.blo.0000534679.75870.5f. View

Wylde V, Sayers A, Odutola A, Gooberman-Hill R, Dieppe P, Blom A . Central sensitization as a determinant of patients' benefit from total hip and knee replacement. Eur J Pain. 2016; 21(2):357-365. PMC: 5245112. DOI: 10.1002/ejp.929. View

Slaven E . Prediction of functional outcome at six months following total hip arthroplasty. Phys Ther. 2012; 92(11):1386-94. DOI: 10.2522/ptj.20110484. View

10.

Power J, Perruccio A, Gandhi R, Veillette C, Davey J, Syed K . Neuropathic pain in end-stage hip and knee osteoarthritis: differential associations with patient-reported pain at rest and pain on activity. Osteoarthritis Cartilage. 2018; 26(3):363-369. DOI: 10.1016/j.joca.2018.01.002. View

11.

Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster J . Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004; 86(5):963-74. DOI: 10.2106/00004623-200405000-00012. View

12.

Martel-Pelletier J, Barr A, Cicuttini F, Conaghan P, Cooper C, Goldring M . Osteoarthritis. Nat Rev Dis Primers. 2016; 2:16072. DOI: 10.1038/nrdp.2016.72. View

13.

Gervais-Hupe J, Pollice J, Sadi J, Carlesso L . Validity of the central sensitization inventory with measures of sensitization in people with knee osteoarthritis. Clin Rheumatol. 2018; 37(11):3125-3132. DOI: 10.1007/s10067-018-4279-8. View

14.

Enomoto H, Fujikoshi S, Ogawa K, Tsuji T, Tanaka S . Relationship Between Pain Reduction and Improvement in Health-Related Quality of Life in Patients with Knee Pain Due to Osteoarthritis Receiving Duloxetine: Exploratory Post Hoc Analysis of a Japanese Phase 3 Randomized Study. J Pain Res. 2020; 13:181-191. PMC: 6983465. DOI: 10.2147/JPR.S211072. View

15.

Ohashi Y, Fukushima K, Inoue G, Uchida K, Koyama T, Tsuchiya M . Central sensitization inventory scores correlate with pain at rest in patients with hip osteoarthritis: a retrospective study. BMC Musculoskelet Disord. 2020; 21(1):595. PMC: 7487668. DOI: 10.1186/s12891-020-03630-6. View

16.

den Boer C, Dries L, Terluin B, van der Wouden J, Blankenstein A, van Wilgen C . Central sensitization in chronic pain and medically unexplained symptom research: A systematic review of definitions, operationalizations and measurement instruments. J Psychosom Res. 2019; 117:32-40. DOI: 10.1016/j.jpsychores.2018.12.010. View

17.

Izumi M, Petersen K, Laursen M, Arendt-Nielsen L, Graven-Nielsen T . Facilitated temporal summation of pain correlates with clinical pain intensity after hip arthroplasty. Pain. 2016; 158(2):323-332. DOI: 10.1097/j.pain.0000000000000764. View

18.

Mayer T, Neblett R, Cohen H, Howard K, Choi Y, Williams M . The development and psychometric validation of the central sensitization inventory. Pain Pract. 2011; 12(4):276-85. PMC: 3248986. DOI: 10.1111/j.1533-2500.2011.00493.x. View

19.

Bachmeier C, March L, Cross M, Lapsley H, Tribe K, Courtenay B . A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage. 2001; 9(2):137-46. DOI: 10.1053/joca.2000.0369. View

20.

Bedson J, Croft P . The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008; 9:116. PMC: 2542996. DOI: 10.1186/1471-2474-9-116. View