Chronic Postoperative Pain, Total Knee Arthroplasty
Conditions
Keywords
Chronic Postoperative Pain, Brain Derived Neurotrophic Factor
Brief summary
Chronic pain is an extremely disabling disease. It is a major public health problem due to the lack of effective therapy. Chronic postoperative pain (CPOP) is defined by a painful symptomatology in the operated area unrelated to previous pain, present for more than 3 months, and without any link to surgical complication. The prevalence of chronicization of postoperative pain is 30% after total knee arthroplasty. Identification of clinical, biological and psychological profiles are crucial to prevent CPOP. A biologic factor, Brain Derived Neurotrophic Factor (BDNF) produced by a variety of cells is a key regulator of neuroplasticity. BDNF is increasingly studied in the mechanisms of cerebral sensitization and pain chronicization. The role of BDNF in pain of patients remains to be explored in a prospective study. The aim of this observational study is to compare the kinetics of BDNF after total knee arthroplasty in patients with and without CPOP. Patients will be included in the study at the preanesthetic consultation. Serum BDNF levels will be measured preoperatively, 48h postoperatively, 3 and 6 months after surgery.
Interventions
DIAGNOSTIC_TESTblood test
blood test to explore BDNF level
Sponsors
Institut National de la Santé Et de la Recherche Médicale, France
University Hospital, Montpellier
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Prospective study to analyze perioperative blood samples in patient after knee replacement surgery. Patients will be included in the study at the pre-anesthetic consultation. Serum BDNF levels will be measured preoperatively, 48h postoperatively, 3 and 6 months after surgery.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Social security affiliation * Adult patients * Signed informed consent * Score ASA (American Society of Anesthesiology) 1-3 * Total knee arthroplasty
Exclusion criteria
* Patient unable to exercise consent * Pregnant women * Vulnerable people * Patients not included in the postoperative rehabilitation program * Patients unable to complete the pain assessment questionnaires * Chronic pain patients (other than knee arthrosis) * Neuropathic pain patients (beforehand) * Inflammatory diseases, progressive cancer, sepsis, immunosuppression known
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| BDNF level | preoperative to 6 months after surgery | assessed by ELISA technique |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Neuropathic pain diagnostic | preoperative to 6 months after surgery | evaluated by neuropathic pain diagnostic questionnaire (DN4) |
| Postoperative rehabilitation | preoperative to 6 months after surgery | evaluated by the Brief Pain Questionary (BPI) |
| Health related quality of life | preoperative to 6 months after surgery | evaluated by the SF-12 Health Survey |
| Pain level | preoperative to 6 months after surgery | evaluated by Visual Analog Scale (VAS) |
| Pain level perception | preoperative to 6 months after surgery | evaluated by the The pain Catastrophizing Scale |
| Assessment of functional capacities in knee arthritis | preoperative to 6 months after surgery | evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) |
| Oxidative stress marker | preoperative to 6 months after surgery | 8-iso-prostaglandin F2α level by biochemical labeling |
| Anxiety and Depression | preoperative to 6 months after surgery | evaluated by the Hospital Anxiety and Depression scale (HAD) |
Countries
France
Outcome results
None listed