Skip to main content
Erschienen in: HSS Journal ® 1/2015

01.02.2015 | Original Article

Preoperative Predictors of Postoperative Opioid Usage, Pain Scores, and Referral to a Pain Management Service in Total Knee Arthroplasty

verfasst von: Trevor R. Banka, MD, Allison Ruel, BA, Kara Fields, MS, Jacques YaDeau, MD, PhD, Geoffrey Westrich, MD

Erschienen in: HSS Journal ® | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Little is known about preoperative predictors of postoperative pain and referral to a recuperative pain management service after total knee arthroplasty (TKA).

Questions/Purposes

We sought to identify the preoperative predictors of postoperative pain scores, referral to a pain management service, and narcotic usage in patients undergoing primary total knee arthroplasty.

Methods

We performed a prospective cohort study of 97 TKAs from a single surgeon. Pre and 6-week postoperative WOMAC, visual analog pain scale (VAS) scores, narcotic usage, and catastrophizing pain scores were collected.

Results

After adjusting for all other variables, higher age and catastrophizing pain scores were associated with lower odds of postoperative opioid usage. Increasing age and BMI were associated with lower odds of being referred to pain management. There was no relationship between self-reported preoperative pain tolerance and postoperative change in WOMAC or VAS pain scores.

Conclusions

This information may help surgeons advise their patients preoperatively and set expectations during the recovery period.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Ayers DC, Franklin PD, Ploutz-Snyder R, Boisvert CB. Total knee replacement outcome and coexisting physical and emotional illness. Clin Orthop. 2005:157–161. Ayers DC, Franklin PD, Ploutz-Snyder R, Boisvert CB. Total knee replacement outcome and coexisting physical and emotional illness. Clin Orthop. 2005:157–161.
2.
Zurück zum Zitat Ayers DC, Franklin PD, Trief PM, Ploutz-Snyder R, Freund D. Psychological attributes of preoperative total joint replacement patients: Implications for optimal physical outcome. J Arthroplasty. 2004;7:125–130.CrossRef Ayers DC, Franklin PD, Trief PM, Ploutz-Snyder R, Freund D. Psychological attributes of preoperative total joint replacement patients: Implications for optimal physical outcome. J Arthroplasty. 2004;7:125–130.CrossRef
3.
Zurück zum Zitat Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain. 2001;3:261–269.CrossRef Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain. 2001;3:261–269.CrossRef
4.
Zurück zum Zitat Brander V, Gondek S, Martin E, Stulberg SD. THE JOHN INSALL AWARD: Pain and depression influence outcome 5 years after knee replacement surgery. Clin Orthop. 2007:21–26. Brander V, Gondek S, Martin E, Stulberg SD. THE JOHN INSALL AWARD: Pain and depression influence outcome 5 years after knee replacement surgery. Clin Orthop. 2007:21–26.
5.
Zurück zum Zitat Brander VA, Stulberg SD, Adams AD, Harden RN, Bruehl S, Stanos SP, Houle T. Ranawat award paper: Predicting total knee replacement pain: A prospective, observational study. Clin Orthop. 2003:27–36. Brander VA, Stulberg SD, Adams AD, Harden RN, Bruehl S, Stanos SP, Houle T. Ranawat award paper: Predicting total knee replacement pain: A prospective, observational study. Clin Orthop. 2003:27–36.
6.
Zurück zum Zitat Caumo W, Schmidt A, Schneider C, Bergmann J, Iwamoto C, Adamatti L, Bandeira D, Ferreira M. Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery. Acta Anaesthesiol Scand. 2002;10:1265–1271.CrossRef Caumo W, Schmidt A, Schneider C, Bergmann J, Iwamoto C, Adamatti L, Bandeira D, Ferreira M. Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery. Acta Anaesthesiol Scand. 2002;10:1265–1271.CrossRef
7.
Zurück zum Zitat Chibnall JT, Tait RC. Confirmatory factor analysis of the pain catastrophizing scale in african american and caucasian workers’ compensation claimants with low back injuries. Pain. 2005;3:369.CrossRef Chibnall JT, Tait RC. Confirmatory factor analysis of the pain catastrophizing scale in african american and caucasian workers’ compensation claimants with low back injuries. Pain. 2005;3:369.CrossRef
8.
Zurück zum Zitat Dalury DF, Jiranek W, Pierson J, Pearson SE. The long-term outcome of total knee patients with moderate loss of motion. The journal of knee surgery. 2003;4:215. Dalury DF, Jiranek W, Pierson J, Pearson SE. The long-term outcome of total knee patients with moderate loss of motion. The journal of knee surgery. 2003;4:215.
9.
Zurück zum Zitat Dieppe P. Osteoarthritis: Time to shift the paradigm: This includes distinguishing between severe disease and common minor disability. BMJ: British Medical Journal. 1999;7194:1299.CrossRef Dieppe P. Osteoarthritis: Time to shift the paradigm: This includes distinguishing between severe disease and common minor disability. BMJ: British Medical Journal. 1999;7194:1299.CrossRef
10.
Zurück zum Zitat Dieppe P, Basler H, Chard J, Croft P, Dixon J, Hurley M, Lohmander S, Raspe H. Knee replacement surgery for osteoarthritis: Effectiveness, practice variations, indications and possible determinants of utilization. Rheumatology. 1999;1:73–83.CrossRef Dieppe P, Basler H, Chard J, Croft P, Dixon J, Hurley M, Lohmander S, Raspe H. Knee replacement surgery for osteoarthritis: Effectiveness, practice variations, indications and possible determinants of utilization. Rheumatology. 1999;1:73–83.CrossRef
11.
Zurück zum Zitat Edwards RR, Bingham CO, Bathon J, Haythornthwaite JA. Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Care & Research. 2006;2:325–332.CrossRef Edwards RR, Bingham CO, Bathon J, Haythornthwaite JA. Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Care & Research. 2006;2:325–332.CrossRef
12.
Zurück zum Zitat Escobar A, Quintana J, Bilbao A, Arostegui I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthritis and cartilage. 2007;3:273–280.CrossRef Escobar A, Quintana J, Bilbao A, Arostegui I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthritis and cartilage. 2007;3:273–280.CrossRef
13.
Zurück zum Zitat Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster J. Health-related quality of life in total hip and total knee arthroplastyA qualitative and systematic review of the literature. The Journal of Bone & Joint Surgery. 2004;5:963–974. Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster J. Health-related quality of life in total hip and total knee arthroplastyA qualitative and systematic review of the literature. The Journal of Bone & Joint Surgery. 2004;5:963–974.
14.
Zurück zum Zitat Fitzgerald JD, Orav EJ, Lee TH, Marcantonio ER, Poss R, Goldman L, Mangione CM. Patient quality of life during the 12 months following joint replacement surgery. Arthritis Care & Research. 2004;1:100–109.CrossRef Fitzgerald JD, Orav EJ, Lee TH, Marcantonio ER, Poss R, Goldman L, Mangione CM. Patient quality of life during the 12 months following joint replacement surgery. Arthritis Care & Research. 2004;1:100–109.CrossRef
15.
Zurück zum Zitat Forsythe ME, Dunbar MJ, Hennigar AW, Sullivan MJ, Gross M. Prospective relation between catastrophizing and residual pain following knee arthroplasty: Two-year follow-up. Pain Research & Management: The Journal of the Canadian Pain Society. 2008;4:335. Forsythe ME, Dunbar MJ, Hennigar AW, Sullivan MJ, Gross M. Prospective relation between catastrophizing and residual pain following knee arthroplasty: Two-year follow-up. Pain Research & Management: The Journal of the Canadian Pain Society. 2008;4:335.
16.
Zurück zum Zitat Gagliese L, Gauthier LR, Macpherson AK, Jovellanos M, Chan VW. Correlates of postoperative pain and intravenous Patient‐Controlled analgesia use in younger and older surgical patients. Pain medicine. 2008;3:299–314.CrossRef Gagliese L, Gauthier LR, Macpherson AK, Jovellanos M, Chan VW. Correlates of postoperative pain and intravenous Patient‐Controlled analgesia use in younger and older surgical patients. Pain medicine. 2008;3:299–314.CrossRef
17.
Zurück zum Zitat Gandhi R, Dhotar H, Razak F, Tso P, Davey JR, Mahomed NN. Predicting the longer term outcomes of total knee arthroplasty. The Knee. 2010;1:15–18.CrossRef Gandhi R, Dhotar H, Razak F, Tso P, Davey JR, Mahomed NN. Predicting the longer term outcomes of total knee arthroplasty. The Knee. 2010;1:15–18.CrossRef
18.
Zurück zum Zitat Hawker GA. Who, when, and why total joint replacement surgery? the patient's perspective. Curr Opin Rheumatol. 2006;5:526–530. Hawker GA. Who, when, and why total joint replacement surgery? the patient's perspective. Curr Opin Rheumatol. 2006;5:526–530.
19.
Zurück zum Zitat Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R, Katz B, Bombardier C, Heck D, Freund D. Health-related quality of life after knee replacement. results of the knee replacement patient outcomes research team study*. The Journal of Bone & Joint Surgery. 1998;2:163–173. Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R, Katz B, Bombardier C, Heck D, Freund D. Health-related quality of life after knee replacement. results of the knee replacement patient outcomes research team study*. The Journal of Bone & Joint Surgery. 1998;2:163–173.
20.
Zurück zum Zitat Hill JC, Lewis M, Sim J, Hay EM, Dziedzic K. Predictors of poor outcome in patients with neck pain treated by physical therapy. Clin J Pain. 2007;8:683–690.CrossRef Hill JC, Lewis M, Sim J, Hay EM, Dziedzic K. Predictors of poor outcome in patients with neck pain treated by physical therapy. Clin J Pain. 2007;8:683–690.CrossRef
21.
Zurück zum Zitat Jellema P, van der Windt, Daniëlle AWM, van der Horst, Henriëtte E, Stalman WA, Bouter LM. Prediction of an unfavourable course of low back pain in general practice: Comparison of four instruments. The British Journal of General Practice. 2007;534:15. Jellema P, van der Windt, Daniëlle AWM, van der Horst, Henriëtte E, Stalman WA, Bouter LM. Prediction of an unfavourable course of low back pain in general practice: Comparison of four instruments. The British Journal of General Practice. 2007;534:15.
22.
Zurück zum Zitat Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the united states from 2005 to 2030. Journal of Bone & Joint Surgery - American Volume. 2007;4:780–785.CrossRef Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the united states from 2005 to 2030. Journal of Bone & Joint Surgery - American Volume. 2007;4:780–785.CrossRef
23.
Zurück zum Zitat Lingard EA, Riddle DL. Impact of psychological distress on pain and function following knee arthroplasty. The Journal of Bone & Joint Surgery. 2007;6:1161–1169. Lingard EA, Riddle DL. Impact of psychological distress on pain and function following knee arthroplasty. The Journal of Bone & Joint Surgery. 2007;6:1161–1169.
24.
Zurück zum Zitat McConnell S, Kolopack P, Davis AM. The western ontario and McMaster universities osteoarthritis index (WOMAC): A review of its utility and measurement properties. Arthritis Care & Research. 2001;5:453–461.CrossRef McConnell S, Kolopack P, Davis AM. The western ontario and McMaster universities osteoarthritis index (WOMAC): A review of its utility and measurement properties. Arthritis Care & Research. 2001;5:453–461.CrossRef
25.
Zurück zum Zitat Memtsoudis SG, Ma Y, Chiu Y, Poultsides L, Della Valle AG, Mazumdar M. Bilateral total knee arthroplasty: Risk factors for major morbidity and mortality. Anesthesia & Analgesia. 2011;4:784–790. Memtsoudis SG, Ma Y, Chiu Y, Poultsides L, Della Valle AG, Mazumdar M. Bilateral total knee arthroplasty: Risk factors for major morbidity and mortality. Anesthesia & Analgesia. 2011;4:784–790.
26.
Zurück zum Zitat Memtsoudis SG, Ma Y, Della Valle AG, Mazumdar M, Gaber-Baylis LK, MacKenzie CR, Sculco TP. Perioperative outcomes after unilateral and bilateral total knee arthroplasty. Anesthesiology. 2009;6:1206.CrossRef Memtsoudis SG, Ma Y, Della Valle AG, Mazumdar M, Gaber-Baylis LK, MacKenzie CR, Sculco TP. Perioperative outcomes after unilateral and bilateral total knee arthroplasty. Anesthesiology. 2009;6:1206.CrossRef
27.
Zurück zum Zitat Murray D, Frost S. Pain in the assessment of total knee replacement. Journal of Bone & Joint Surgery, British Volume. 1998;3:426–431.CrossRef Murray D, Frost S. Pain in the assessment of total knee replacement. Journal of Bone & Joint Surgery, British Volume. 1998;3:426–431.CrossRef
28.
Zurück zum Zitat Osman A, Barrios FX, Gutierrez PM, Kopper BA, Merrifield T, Grittmann L. The pain catastrophizing scale: Further psychometric evaluation with adult samples. J Behav Med. 2000;4:351–365.CrossRef Osman A, Barrios FX, Gutierrez PM, Kopper BA, Merrifield T, Grittmann L. The pain catastrophizing scale: Further psychometric evaluation with adult samples. J Behav Med. 2000;4:351–365.CrossRef
29.
Zurück zum Zitat Rakel BA, Blodgett NP, Bridget Zimmerman M, Logsden-Sackett N, Clark C, Noiseux N, Callaghan J, Herr K, Geasland K, Yang X. Predictors of postoperative movement and resting pain following total knee replacement. Pain. 2012. Rakel BA, Blodgett NP, Bridget Zimmerman M, Logsden-Sackett N, Clark C, Noiseux N, Callaghan J, Herr K, Geasland K, Yang X. Predictors of postoperative movement and resting pain following total knee replacement. Pain. 2012.
30.
Zurück zum Zitat Riddle DL, Jiranek WA. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clinical Orthopaedics and Related Research®. 2010;3:798–806.CrossRef Riddle DL, Jiranek WA. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clinical Orthopaedics and Related Research®. 2010;3:798–806.CrossRef
31.
Zurück zum Zitat Singh JA, Kwoh CK, Boudreau RM, Lee GC, Ibrahim SA. Hospital volume and surgical outcomes after elective hip/knee arthroplasty: A risk-adjusted analysis of a large regional database. Arthritis & Rheumatism. 2011;8:2531–2539.CrossRef Singh JA, Kwoh CK, Boudreau RM, Lee GC, Ibrahim SA. Hospital volume and surgical outcomes after elective hip/knee arthroplasty: A risk-adjusted analysis of a large regional database. Arthritis & Rheumatism. 2011;8:2531–2539.CrossRef
32.
Zurück zum Zitat Stefánsdóttir A. Higher early mortality with simultaneous rather than staged bilateral TKAs: Results from the swedish knee arthroplasty register. Clin Orthop. 2008;12:3066–3070.CrossRef Stefánsdóttir A. Higher early mortality with simultaneous rather than staged bilateral TKAs: Results from the swedish knee arthroplasty register. Clin Orthop. 2008;12:3066–3070.CrossRef
33.
Zurück zum Zitat Sullivan MJ, Bishop S, Pivik J. The pain catastrophizing scale. Development and Validation. Psychological Assessment. 1995;4:524–532.CrossRef Sullivan MJ, Bishop S, Pivik J. The pain catastrophizing scale. Development and Validation. Psychological Assessment. 1995;4:524–532.CrossRef
34.
Zurück zum Zitat Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefebvre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;1:52–64.CrossRef Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefebvre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;1:52–64.CrossRef
35.
Zurück zum Zitat Tubach F, Ravaud P, Baron G, Falissard B, Logeart I, Bellamy N, Bombardier C, Felson D, Hochberg M, van der Heijde D. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: The minimal clinically important improvement. Ann Rheum Dis. 2005;1:29–33.CrossRef Tubach F, Ravaud P, Baron G, Falissard B, Logeart I, Bellamy N, Bombardier C, Felson D, Hochberg M, van der Heijde D. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: The minimal clinically important improvement. Ann Rheum Dis. 2005;1:29–33.CrossRef
36.
Zurück zum Zitat Urban M, Chisholm M, Wukovits B. Are postoperative complications more common with single-stage bilateral (SBTKR) than with unilateral knee arthroplasty: Guidelines for patients scheduled for SBTKR. Age (years). 2006;11:68–11. Urban M, Chisholm M, Wukovits B. Are postoperative complications more common with single-stage bilateral (SBTKR) than with unilateral knee arthroplasty: Guidelines for patients scheduled for SBTKR. Age (years). 2006;11:68–11.
37.
Zurück zum Zitat Williams DP, Blakey CM, Hadfield SG, Murray DW, Price AJ, Field RE. Long-term trends in the oxford knee score following total knee replacement. Bone Joint J. 2013;1:45–51.CrossRef Williams DP, Blakey CM, Hadfield SG, Murray DW, Price AJ, Field RE. Long-term trends in the oxford knee score following total knee replacement. Bone Joint J. 2013;1:45–51.CrossRef
38.
Zurück zum Zitat Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee replacement: Comparison of mid-term results. J Arthroplasty. 2009;2:210–216.CrossRef Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee replacement: Comparison of mid-term results. J Arthroplasty. 2009;2:210–216.CrossRef
39.
Zurück zum Zitat Wylde V, Dieppe P, Hewlett S, Learmonth I. Total knee replacement: Is it really an effective procedure for all?. The Knee. 2007;6:417.CrossRef Wylde V, Dieppe P, Hewlett S, Learmonth I. Total knee replacement: Is it really an effective procedure for all?. The Knee. 2007;6:417.CrossRef
40.
Zurück zum Zitat Xie F, Lo N, Pullenayegum EM, Tarride J, O'Reilly DJ, Goeree R, Lee H. Evaluation of health outcomes in osteoarthritis patients after total knee replacement: A two-year follow-up. Health and quality of life outcomes. 2010;1:1–6. Xie F, Lo N, Pullenayegum EM, Tarride J, O'Reilly DJ, Goeree R, Lee H. Evaluation of health outcomes in osteoarthritis patients after total knee replacement: A two-year follow-up. Health and quality of life outcomes. 2010;1:1–6.
Metadaten
Titel
Preoperative Predictors of Postoperative Opioid Usage, Pain Scores, and Referral to a Pain Management Service in Total Knee Arthroplasty
verfasst von
Trevor R. Banka, MD
Allison Ruel, BA
Kara Fields, MS
Jacques YaDeau, MD, PhD
Geoffrey Westrich, MD
Publikationsdatum
01.02.2015
Verlag
Springer US
Erschienen in
HSS Journal ® / Ausgabe 1/2015
Print ISSN: 1556-3316
Elektronische ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-014-9418-4

Weitere Artikel der Ausgabe 1/2015

HSS Journal ® 1/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.