Erschienen in:
01.01.2015 | Clinical Research
Abnormal Quantitative Sensory Testing is Associated With Persistent Pain One Year After TKA
verfasst von:
Anthony Wright, PhD, Penny Moss, PhD, Karen Sloan, MSc, Richard J. Beaver, FRACS, Jarle B. Pedersen, MClinPhysio, Gerard Vehof, MClinPhysio, Henrik Borge, MClinPhysio, Luca Maestroni, MClinPhysio, Philip Cheong, MManipTher
Erschienen in:
Clinical Orthopaedics and Related Research®
|
Ausgabe 1/2015
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Abstract
Background
Up to 15% of patients report at least moderate persistent pain after TKA. Such pain may be associated with the presence of widespread hyperalgesia and neuropathic-type pain.
Questions/purposes
We asked if there was a difference among patients who report moderate to severe pain or no pain at least 12 months after TKA regarding (1) pressure pain threshold, (2) thermal (cold/heat) pain and detection thresholds, and (3) self-reported neuropathic pain.
Patients and Method
Fifty-three volunteers were recruited from patients reporting no pain or moderate to severe pain, according to the Knee Society Score©. Differences between the moderate-to-severe and no-pain groups regarding pressure pain, heat and cold thresholds, and self-reported neuropathic-type pain were analyzed using independent t-tests.
Results
Patients in the moderate-to-severe pain group exhibited reduced pressure pain threshold in the knee with the TKA (p = 0.025) and at the elbow (p = 0.002). This group also showed greater pain sensitivity to cold at the knee (p = 0.008) and elbow (p = 0.010), and increased heat pain sensitivity at the elbow (p = 0.032). Cold and heat detection thresholds were impaired in this group at the elbow (cold, p = 0.034; heat, p = 0.010), although only heat detection was impaired at the knee (p = 0.009). The moderate-to-severe pain group also reported more neuropathic-type pain (p = 0.001).
Conclusion
Persistent pain after TKA was associated with widespread pressure, cold hyperalgesia, and greater neuropathic-type pain.
Level of Evidence
Level III, prognostic study.