Osteoarthritis, Pain, Postoperative Pain, Surgery
Conditions
Keywords
Osteoarthritis, Pain, Postoperative Pain
Brief summary
Painful osteoarthritis (OA) is the 4th largest cause of disability in the UK. Preoperative temporal summation, a measure of central pain facilitation, has been shown to predict postoperative pain after total knee replacement surgery (TKR). The assessment of the brain's response to noxious stimuli using non-invasive functional MRI (fMRI) may be key in identifying imaging biomarkers within the brain that map central sensitization changes seen in OA. fMRI may help explain why up to 20% of patients undergoing TKR surgery develop persistent post-operative pain. To test these concepts the study aims to functionally characterise the brain activity related to temporal summation of pain in healthy individuals and OA patients using a novel fMRI cuff algometer. Assessment of outcomes in terms of pain and function will be performed 6 months post TKR surgery
Interventions
PROCEDURETotal Knee Replacement Surgery
All chronic knee osteoarthritis patients will be recruited as they are on the NHS waiting list for a total knee replacement. Only this group will undergo the procedure
Sponsors
Aalborg University
Medical Research Council
Arthritis Research UK
Royal College of Surgeons of Edinburgh
University of Nottingham
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* OA Group Unilateral Knee OA No previous knee surgery Able to give informed consent Age \> 40 years \- Healthy Volunteers Group No OA or knee pain Able to give informed consent Age \> 40 years
Exclusion criteria
-OA Group Major medical, psychiatric, neurological Cx Other chronic pain condition (fibromyalgia) Contraindications to MRI Active Cancer Neuropathic drug treatment -Healthy Volunteers Group Pregnancy Lower limb pain or previous knee surgery Contraindications to MRI Active Cancer Major medical, psychiatric, neurological condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Brain activity related to temporal summation of pain in healthy individuals and OA patients using a novel fMRI cuff algometer. | 6 months post total knee replacement surgery | Using BOLD fMRI we aim to assess the difference in neural brain activity between patients with chronic knee OA pain and a group of healthy volunteers and to assess the reversal of this activity pattern 6 months post TKR surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of knee pain using the Visual Analogue Scale for Pain (0-10) | 6 months post total knee replacement surgery | Pain using visual analogue scale |
| Assessment of improvement in the Oxford Knee Score | 6 months post total knee replacement surgery | pain and function outcome measure |
| Assessment of change in healthy related quality of life measure using the EQ5D-5L questionnaire | 6 months post total knee replacement | quality of life index measure |
Countries
United Kingdom
Contacts
Primary ContactThomas Kurien, BMBS
Backup ContactBrigitte E Scammell, FRCS
Outcome results
None listed