Knee Arthritis, Hip Arthritis
Conditions
Keywords
Knee Arthroplasty, Hip Arthroplasty
Brief summary
To investigate the association between grip strength and preoperative pain threshold as measured by pressure algometer and validated pain outcome surveys.
Detailed description
A minimum of 200 patients, 100 hip and 100 knee arthroplasty participants, will be recruited for this study. Preoperatively, patient pain threshold will be recorded both objectively (Pressure algometer) and subjectively (brief pain inventory). In terms of location, objectively this will be tested during the preoperative visit in clinic by the approved, trained research staff, as well as the subjective brief pain inventory. Objective pain measure: Pressure algometer will be obtained in the standard fashion as follows: the probe is applied at a 90 degree angle to the skin at a constant rate of 10kPa/s to minimize the impact of the examiner's reaction time on recorded pain thresholds. The participant is instructed by the measurer to say stop when the sensation of pressure became the very first sensation of pain. There will be three spots to test patients, one for familiarity of the testing and the other 2 for data collection. 1. This is initially performed once on ipsilateral the tibialis anterior as a warm up. 2. Then 3 measurements are taken on the operative medial epicondyle (for TKA) or ipsilateral lateral iliac crest (for THA) and averaged for the official score. 3. Lastly, three measurements are also taken on the contralateral olecranon to measure systemic pain sensitivity. If the contralateral elbow has had prior surgery or active bursitis, the ipsilateral elbow will be used. Of important note, the algometer has a max force lock out of 100N to prevent any harm to the patient. 4. Dominant Hand Grip strength measured by the average of 3 attempts on a Dynamometer. Subjectively, the brief pain inventory is a validated pain outcome measure which will be filled out by the participant during their preoperative clinic visit. Postoperative, the study team will ask the participant at the 6 week mark: 1. How many and what kind of opiates did the participant require? 2. How many days did the participant require opiates? 3. Did the participant require a refill? a. If so, did the participant have this filled in clinic preemptively or place a phone call to the office?
Interventions
DEVICEWagner Pain Algometer
applied at a 90 degree angle to the skin at a constant rate of 10kPa/s to minimize the impact of the examiner's reaction time on recorded pain thresholds
DEVICEDynamometer
Dominant Hand Grip strength measured by the average of 3 attempts
Sponsors
Duke University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* any participant undergoing elective primary total knee arthroplasty or total hip arthroplasty * Participants of the following investigators will be approached: Bolognesi, Wellman, Attarian, and Seyler
Exclusion criteria
* previous hip or knee surgery in the operative joint
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| physical therapy performance on the first day after surgery | post op day 1 | distance walked in feet on post op day 1 |
| Inpatient length of stay in days | 1-3 on days average | amount of time in hospital |
| pain control average visual analogue scale 1 - 10 of hospital stay | 1-3 days on average | averaging the subjective pain control |
| discharge location placement | 1 - 3 days on average | home, rehab or nursing facility |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Outpatient narcotic consumption multiple refills needed | 6-week from surgery | number of refills needed requiring provider time outside of scheduled appointment |
| Outpatient narcotic consumption refill needed | 6-week from surgery | need for refill prescription, yes or no |
| Outpatient narcotic pill consumption | 6-week from surgery | narcotic equivalents consumed by patient in morphine equivalents. we will convert all medicine to the standard unit |
Other
| Measure | Time frame | Description |
|---|---|---|
| Complications short term after surgery | 6-week from surgery | Inpatient complications while in the hospital |
| Complications long term after surgery | surgery to 1yr postoperative | Outpatient complications seen after discharge |
Countries
United States
Outcome results
None listed