Chronic Post-operative Pain, Osteo Arthritis Knee
Conditions
Brief summary
Osteoarthritis (OA) is disease in which the joint breaks down, causing pain. The decision to surgically replace the knee, a procedure called total knee arthroplasty (TKA), depends on x-ray results as well as pain and dysfunction. Despite TKA resulting in good outcomes for most patients, between 1 in 10 and 1 in 5 patients remain in significant pain - i.e., are 'TKA non-responders'. Two pain conditions - myofascial pain syndrome (MPS) and central sensitization - frequently coexist with signs of OA and may contribute to a TKA non-responder profile. MPS, caused by knots within skeletal muscle, can contribute to an OA patient's pain and dysfunction. In central sensitization, faulty pain sensing leads to increased pain sensitivity. However, there is currently no established process to identify these sources of pain and potential associated TKA non-responder risk. Our research aims conduct a pilot study to examine the impact of pain diagnosis tools to help orthopedic surgeons identify potential TKA nonresponders. This new approach may increase healthcare efficiency (reduce TKA waitlist and length of hospital stay), and help patients receive the right care at the right time.
Interventions
OTHERn/a, observational
n/a, observational study
Sponsors
University Health Network, Toronto
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* adult patients aged 18 or older * on the waitlist for TKA (unilateral) for knee osteoarthritis
Exclusion criteria
* undergoing revision or non-elective surgery * unable to provide informed consent and follow study procedures
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clinical prediction model feasibility as determined by: Recruitment rate, follow-up at 12 months post-op, multivariable logistic regression | 21 months |
Secondary
| Measure | Time frame |
|---|---|
| Likelihood of neuropathic pain component, as assessed by the painDETECT questionnaire | 21 months |
| Symptoms of central sensitisation, as assessed by the Central Sensitization Inventory questionnaire | 21 months |
| Physical function, as assessed by the Aggregate Locomotor Function test | 21 months |
| Pain regions and pain pattern, as assessed by Pain Body Diagram | 21 months |
| Pain facilitation, as assessed by Temporal Summation of Pain (wind-up) | 21 months |
| Deep tissue pain sensitivity, as assessed by Pain Pressure Threshold | 21 months |
| Prevalence of myofascial trigger points | 21 months |
Countries
Canada
Contacts
Primary ContactOA pain research coordinator
Outcome results
None listed