Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Die Folgen des Klimwandels haben einen direkten Einfluss auf die Primärversorgung in Deutschland: Hitzeschutz insbesondere bei älteren Patienten, die Zunahme von Infektionen und die Verlängerung der Allergiesesaison spielen medizinisch eine bedeutsame Rolle. Aber auch in der Prävention und der Aufklärung der Patienten kommt den Hausärztinnen und -ärzten eine besondere Rolle zu. Direkt aus der Praxis berichtet im Live-Webinar am 13. Mai von 18 bis 19 Uhr unser Experte Dr. med. Robin Maitra.
Erweiterte Suche
Anmelden
nach oben
Current Reviews in Musculoskeletal Medicine
Erschienen in: Current Reviews in Musculoskeletal Medicine 4/2016

09.09.2016 | Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Towards an understanding of the painful total knee: what is the role of patient biology?

verfasst von: Stephen Preston, Massimo Petrera, Christopher Kim, Michael G. Zywiel, Rajiv Gandhi

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Abstract

Total knee arthroplasty (TKA) remains the treatment of choice for end-stage osteoarthritis of the knee. With an aging population, the demand for TKA continues to increase, placing a significant burden on a health care system that must function with limited resources. Although generally accepted as a successful procedure, 15–30 % of patients report persistent pain following TKA. Classically, pain generators have been divided into intra-articular and extra-articular causes. However, there remains a significant subset of patients for whom pain remains unexplained. Recent studies have questioned the role of biology (inflammation) in the persistence of pain following TKA. This article aims to serve as a review of previously identified causes of knee pain following TKA, as well as to explore the potential role of biology as a predictor of pain following knee replacement surgery.
Literatur
1.
Statistics Canada. Population projections: Canada, the provinces and territories. The Daily; May 26, 2010. www.​statcan.​gc.​ca (accessed 16 May 2016).
2.
3.
An Aging World 2001, U.S. Department of Commerce, UN Department of Public Information, DP/2264, March 2002.
4.
Lafortune G, Balestat G. “Trends in severe disability among elderly people: assessing the evidence in 12 OECD countries and the future implications”, OECD Health Working Papers, No. 26, OECD Publishing. 2007.
5.
Aletaha D, Smolen JS. The American College of Rheumatology N (ACR-N) debate: going back into the middle of the tunnel? Comment on the articles by Siegel and Zhen and by Boers. Arthritis Rheum. 2006;54:377–8.CrossRefPubMed
6.
Perruccio AV, Power JD, Badley EM. Revisiting arthritis prevalence projections—it’s more than just the aging of the population. J Rheumatol. 2006;33:1856–62.PubMed
7.
Felson DT. An update on the pathogenesis and epidemiology of osteoarthritis. Radiol Clin N Am. 2004;42:1–9.CrossRefPubMed
8.
Canadian Institute for Health Information. Methodological Notes: CJRR Quick Stats, September 2010, 2008–2009 Data; Overview of Hip and Knee Replacements. 2010. Ottawa, ON, CIHI, 2010.
9.
Canadian Institute for Health Information. Patient Cost Estimation, Fiscal year 2008–2009.
10.
Healthcare Cost and Utilization Project. National statistics, agency for healthcare research and quality. U.S.: Department of Health & Human Services; 2009.
11.
Losina E, Thornhill TS, Rome BN, et al. The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic. J Bone Joint Surg Am. 2012;94:201–7.CrossRefPubMedPubMedCentral
12.
Buckwalter JA, Heckman JD, Petrie DP, AOA. An AOA critical issue: aging of the North American population: new challenges for orthopaedics. J Bone Joint Surg Am. 2003;85-A:748–58.CrossRefPubMed
13.
14.
Power JD, Perruccio AV, Desmeules M, Lagace C, Badley EM. Ambulatory physician care for musculoskeletal disorders in Canada. J Rheumatol. 2006;33:133–9.PubMed
15.
Shipton D, Badley EM, Mahomed NN. Critical shortage of orthopaedic services in Ontario, Canada. J Bone Joint Surg Am. 2003;85-A:1710–5.CrossRefPubMed
16.
Lavernia C, Lee DJ, Hernandez VH. The increasing financial burden of knee revision surgery in the United States. Clin Orthop Relat Res. 2006;446:221–6.CrossRefPubMed
17.
Mehrotra C, Remington PL, Naimi TS, Washington W, Miller R. Trends in total knee replacement surgeries and implications for public health, 1990–2000. Public Health Rep. 2005;120:278–82.PubMedPubMedCentral
18.
Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012;2, e000435.CrossRefPubMedPubMedCentral
19.
Vuorenmaa M, Ylinen J, Kiviranta I, et al. Changes in pain and physical function during waiting time and 3 months after knee joint arthroplasty. J Rehabil Med. 2008;40:570–5.CrossRefPubMed
20.•
Singh JA, Lewallen DG. Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes. BMC Musculoskelet Disord. 2014;15:440. This reference demonstrates that despite advances in surgical technique, implant design and perioperative care; outcomes in TKA are not improving over time. This underscores the importance of identifying the cause(s) of persistent pain following TKA so that targeted interventions may be developed.CrossRefPubMedPubMedCentral
21.
Scott CE, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg (Br). 2010;92(9):1253–8.CrossRef
22.
Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty. Acta Orthop Scan. 2000;71(3):262–7.CrossRef
23.
Escobar A, Riddle DL. Concordance between important change and acceptable symptom state following knee arthroplasty: the role of baseline scores. Osteoarthr Cartil. 2014;22:1107–10.CrossRefPubMed
24.
Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012;27(8 suppl.):61–5.
25.
Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res. 2011;469:2992–4.CrossRefPubMedPubMedCentral
26.
Senthi S, Munro JT, Pitto RP. Infection in total hip replacement: meta-analysis. Int Orthop. 2011;35:253.CrossRefPubMed
27.
Parratte S, Pagnano MW. Instability after total knee arthroplasty. J Bone Joint Surg Am. 2008;90:184–94.PubMed
28.
Parvizi J, Zmistowski B, Adeli B. Periprosthetic joint infection: treatment options. Orthopedics. 2010;33:659.PubMed
29.
Azzam MG, Roy ME, Whiteside LA. Second generation locking mechanisms and ethylene oxide sterilization reduce tibial insert backside damage in total knee arthroplasty. J Arthroplasty. 2011;26(4):523.CrossRefPubMed
30.
Griffin WL, Fehring TK, Pomeroy DL, et al. Sterilization and wear-related failure in first- and second-generation press fit condylar total knee arthroplasty. Clin Orthop Relat Res. 2007;464:16.PubMed
31.
Schroer WC, Berend KR, Lombardi AV, et al. Why are total knees failing today? Etiology of total knee revision in 2010 and 2011. J Arthroplasty. 2013;28(1 suppl.):116–9.
32.
Abu-Amer Y, Darwech I, Clohisy JC. Aseptic loosening of total joint replacements: mechanisms underlying osteolysis and potential therapies. Arthritis Res Ther. 2007;9 suppl 1:S6.CrossRefPubMedPubMedCentral
33.
34.
He JY, Jiang LS, Dai LY. Is patellar resurfacing superior than nonresurfacing in total knee arthroplasty? A meta-analysis of randomized trials. Knee. 2011;18:137–44.CrossRefPubMed
35.
Bhattee G, Moonot P, Govindaswamy R, Pope A, Fiddian N, Harvey A. Does malrotation of components correlate with patient dissatisfaction following secondary patellar resurfacing? Knee. 2014;21:247–51.CrossRefPubMed
36.
Mockford BJ, Beverland DE. Secondary resurfacing of the patella in mobile-bearing total knee arthroplasty. J Arthroplasty. 2005;20:898–902.CrossRefPubMed
37.
38.
39.
Lesh ML, Schneider DJ, Deol G, et al. The consequences of anterior femoral notching in total knee arthroplasty. A biomechanical study. J Bone Joint Surg Am. 2000;82:1096–101.CrossRefPubMed
40.
Zalzal P, Backstein D, Gross AE, Papini M. Notching of the anterior femoral cortex during total knee arthroplasty characteristics that increase local stresses. J Arthroplasty. 2006;21:737–43.CrossRefPubMed
41.
Ritter MA, Thong AE, Keating EM, et al. The effect of femoral notching during total knee arthroplasty on the prevalence of postoperative femoral fractures and on clinical outcome. J Bone Joint Surg Am. 2005;87:2411–4.PubMed
42.
43.
Ortiguera CJ, Berry DJ. Patellar fracture after total knee arthroplasty. J Bone Joint Surg Am. 2002;84:532–40.CrossRefPubMed
44.
Chalidis BE, Tsiridis E, Tragas AA, et al. Management of periprosthetic patellar fractures. A systematic review of literature. Injury. 2007;38:714–24.CrossRefPubMed
45.
Grace JN, Sim FH. Fracture of the patella after total knee arthroplasty. Clin Orthop Relat Res. 1988;230:168–75.
46.
Stoffel KK, Flivik G, Yates PJ, Nicholls RL. Intraosseous blood flow of the everted or laterally-retracted patella during total knee arthroplasty. Knee. 2007;14:434–8.CrossRefPubMed
47.
Kayler DE, Lyttle D. Surgical interruption of patellar blood supply by total knee arthroplasty. Clin Orthop Relat Res. 1988;229:221–7.
48.
Felix NA, Stuart MJ, Hanssen AD. Periprosthetic fractures of the tibia associated with total knee arthroplasty. Clin Orthop Relat Res. 1997;345:113–24.CrossRef
49.
Dennis DA. Periprosthetic fractures following total knee arthroplasty. Instr Course Lect. 2001;50:379–89.PubMed
50.
Lavand’homme PM, Grosu I, France MN, Thienpont E. Pain trajectories identify patients at risk of persistent pain after knee arthroplasty: an observational study. Clin Orthop Relat Res. 2014;472:1409–15.CrossRefPubMed
51.
Deumens R, Grosu I, Thienpont E. Surgically induced neuropathic pain: understanding the perioperative process. Ann Surg 2013.
52.
53.
Brander VA, Stulberg SD, Adams AD, Harden RN, Bruehl S, Stanos SP, et al. Predicting total knee replacement pain: a prospective, observational study. Clin Orthop Relat Res. 2003;416:27–36.CrossRef
54.
Hirschmann MT, Testa E, Amsler F, Friederich NF. The unhappy total knee arthroplasty (TKA) patient: higher WOMAC and lower KSS in depressed patients prior and after TKA. Knee Surg Sports Traumatol Arthrosc. 2013;21(10):2405–11.CrossRefPubMed
55.•
Lewis GN, Rice DA, McNair PJ, Kluger M. Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis. Br J Anaesth. 2015;114(4):551–61. This is the most recent review of painful TKA and it summarizes the intra-articular and extra-articular causes of pain quite nicely. However, the potential role of biology was not explored.CrossRefPubMed
56.
Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42(8):1722–8.CrossRefPubMed
57.
Brander V, Gondek S, Martin E, Stulberg SD. Pain and depression influence outcome 5 years after knee replacement surgery. Clin Orthop Relat Res. 2007;464:21–6.PubMed
58.
Pearle AD et al. Elevated high-sensitivity C-reactive protein levels are associated with local inflammatory findings in patients with osteoarthritis. Osteoarthr Cartil. 2007;15(5):516–23.CrossRefPubMed
59.
Gandhi R, Takahashi M, Smith H, Rizek R, Mahomed NN. The synovial fluid adiponectin-leptin ratio predicts pain with knee osteoarthritis. Clin Rheumatol. 2010;29(11):1223–8.CrossRefPubMed
60.
Sturmer T et al. Severity and extent of osteoarthritis and low grade systemic inflammation as assessed by high sensitivity C reactive protein. Ann Rheum Dis. 2004;63(2):200–5.CrossRefPubMedPubMedCentral
61.
Sharif M, Shepstone L, Elson C, Dieppe P, Kirwan J. Increased serum C reactive protein may reflect events that precede radiographic progression in osteoarthritis of the knee. Ann Rheum Dis. 2000;59:71–4.CrossRefPubMedPubMedCentral
62.
Conrozier T, Carlier M, Mathieu P, Colson F, Debard A, Richard S, et al. Serum levels of YKL-40 and C reactive protein in patients with hiposteoarthritis and healthy subjects: a cross sectional study. Ann Rheum Dis. 2000;59:828–31.CrossRefPubMedPubMedCentral
63.
Honsawek S, Deepaisarnsakul B, Tanavalee A, Sakdinakiattikoon M, Ngarmukos S, et al. Relationship of serum IL-6, C-reactive protein, erythrocyte sedimentation rate, and knee skin temperature after total knee arthroplasty: a prospective study. Int Orthop. 2011;35(1):31–5.CrossRefPubMed
64.
Smith JW, Martins TB, Gopez E, Johnson T, Hill HR, Rosenberg TD. Significance of C-reactive protein in osteoarthritis and total knee arthroplasty outcomes. Ther Adv Musculoskelet Dis. 2012;4(5):315–25.CrossRefPubMedPubMedCentral
65.•
Gandhi R, Santone D, Takahashi M, Dessouki O, Mahomed NN. Inflammatory predictors of ongoing pain 2 years following knee replacement surgery. Knee. 2013;20(5):316–8. This is one of the first articles to demonstrate the importance of inflammation in predicting the persistence of knee beyond the acute inflammatory phase following TKA.CrossRefPubMed
66.
Leopold SS, Casnellie MT, Warme WJ, Dougherty PJ, Wingo ST, Shott S. Endogenous cortisol production in response to knee arthroscopy and total knee arthroplasty. J Bone Joint Surg. 2003;85A:2163–7.CrossRef
67.
Hall GM, Peerbhoy D, Shenkin A, Parker CJR, Salmon P. Relationship of the functional recovery after hip arthroplasty to the neuroendocrine and inflammatory responses. Br J Anesth. 2001;87:537–42.CrossRef
68.
Kennedy BC, Hall GM. Neuroendocrine and inflammatory aspects of surgery: do they affect outcome? Acta Anaesthesiol Belg. 1999;50:205–9.PubMed
69.
Ugraş AA, Kural C, Kural A, Demirez F, Koldaş M, Cetinus E. Which is more important after total knee arthroplasty: local inflammatory response or systemic inflammatory response? Knee. 2011;18(2):113–6.CrossRefPubMed
70.
Sager HB, Heidt T, Hulsmans M, Dutta P, Courties G, Sebas M, et al. Targeting interleukin-1β reduces leukocyte production after acute myocardial infarction. Circulation. 2015;132(20):1880–90.PubMedPubMedCentral
71.
Prasongsukarn K, Abel JG, Jamieson WRE, Cheung A, Russell JA, Walley KR, et al. The effects of steroids on the occurrence of postoperative atrial fibrillation after coronary artery bypass grafting surgery: a prospective randomized trial. J Thorac Cardiovasc Surg. 2005;130:93–8.CrossRefPubMed
72.
Jules-Elysee KM, Wilfred SE, Memtsoudis SG, Kim DH, YaDeau JT, Urban MK, et al. Steroid modulation of cytokine release and desmosine levels in bilateral total knee replacement: a prospective, double-blind, randomized controlled trial. J Bone Joint Surg Am. 2012;94:2120–7.CrossRefPubMed
73.
Pang HN, Lo NN, Yang KY, Chong HC, Yeo SJ. Peri-articular steroid injection improves the outcome after unicondylar knee replacement: a prospective, randomized controlled trial with a two-year follow-up. J Bone Joint Surg (Br). 2008;90-B:738–44.CrossRef
Metadaten
Titel
Towards an understanding of the painful total knee: what is the role of patient biology?
verfasst von
Stephen Preston
Massimo Petrera
Christopher Kim
Michael G. Zywiel
Rajiv Gandhi
Publikationsdatum
09.09.2016
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 4/2016
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-016-9363-6

Weitere Artikel der Ausgabe 4/2016

Current Reviews in Musculoskeletal Medicine 4/2016 Zur Ausgabe

Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Radiographic outcomes following femoroacetabular impingement correction with open surgical management: a systematic review

Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Pediatric anterior cruciate ligament reconstruction outcomes

Pediatric Orthopedics (B Heyworth, Section Editor)

What is new in idiopathic clubfoot?

Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Outcomes following long head of biceps tendon tenodesis

Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Radiographic outcomes reporting after arthroscopic management of femoroaceabular impingement: a systematic review

Social Media and Orthopedics (P Sculco, Section Editor)

Social media and your practice: navigating the surgeon-patient relationship

Arthropedia

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

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Update Orthopädie und Unfallchirurgie

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

Newsletter bestellen
Bildnachweise