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Longitudinal Postoperative Course of Pain and Dysfunction Following Total Knee Arthroplasty
Journal article   Open access   Peer reviewed

Longitudinal Postoperative Course of Pain and Dysfunction Following Total Knee Arthroplasty

Katherine Hadlandsmyth, M Bridget Zimmerman, Roohina Wajid, Kathleen A Sluka, Keela Herr, Charles R Clark, Nicolas O Noiseux, John J Callaghan and Barbara A Rakel
The Clinical journal of pain, Vol.34(4), pp.332-338
04/2018
DOI: 10.1097/AJP.0000000000000540
PMCID: PMC5775938
PMID: 28731957
url
https://www.ncbi.nlm.nih.gov/pmc/articles/5775938View
Open Access

Abstract

Although the majority of patients undergoing total knee arthroplasty (TKA) report substantial improvement in pain and function, a significant subset experience persistent postsurgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6-weeks post-TKA, to 6-months outcomes. This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6-weeks and 6-months post-TKA. In this longitudinal study of 223 participants, assessments of analgesic intake, depression, anxiety, pain catastrophizing, dysfunction, resting and range of motion pain, and pain sensitivity were completed at 6-weeks post-TKA. Analgesic intake, pain ratings, and dysfunction data were also collected at 6-months post-TKA. Pain and dysfunction ratings were divided into none-mild and moderate-severe categories. Between 6-weeks and 6-months post-TKA, 75% of the sample stayed in the same pain category, 20% improved, and 5% worsened. In terms of functional changes between 6 weeks and 6 months, 65% of the sample stayed in the same functional category, whereas 31% improved and 5% worsened. These findings demonstrate that the majority of patients' pain and functioning remains stable between 6 weeks and 6 months post-TKA. However, a notable subset continues to improve or worsen in pain and functioning and the current study identifies variables associated with these changes.
 Analgesics - therapeutic use Pain, Postoperative - drug therapy Pain, Postoperative - psychology Humans Middle Aged Anxiety - psychology Male Range of Motion, Articular Depression - psychology Arthroplasty, Replacement, Knee Female Pain Threshold Aged Osteoarthritis, Knee - physiopathology Osteoarthritis, Knee - surgery Pain Measurement Pain, Postoperative - physiopathology Longitudinal Studies Catastrophization - psychology

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