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Pain catastrophizing and pre-operative psychological state are predictive of chronic pain after joint arthroplasty of the hip, knee or shoulder: results of a prospective, comparative study at one year follow-up
International Orthopaedics ( IF 2.7 ) Pub Date : 2022-08-23 , DOI: 10.1007/s00264-022-05542-7
Alexandre Hardy 1 , Marie-Hélène Sandiford 2 , Christophe Menigaux 2 , Thomas Bauer 2 , Shahnaz Klouche 3 , Philippe Hardy 2
Affiliation  

Purpose

To assess the relationship between pre-operative psychological state, postoperative pain and function one year after total shoulder, hip or knee arthroplasty.

Methods

Patients undergoing shoulder, hip or knee arthroplasty between March 2014 and November 2015 were included. Pain catastrophizing score (PCS) was determined preoperatively, at six months and at one year follow-up. Joint pain at rest was quantified using a Visual Analogue Scale (0‒100). Depressive symptoms were measured using the Beck Depression Inventory or Geriatric Depression Score, situational anxiety and dispositional anxiety were measured using the State-Trait Inventory and joint function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index for the hip and knee and Oxford Shoulder Score for the shoulder.

Results

A total of 266 patients were included (65% female; mean (± SD) age: 71.8 ± 10.3 years; mean body mass index: 27.5 ± 5.0 kg/m2). Pre-operative PCS was significantly correlated with pain > 30/100 at one year and with functional scores, for all joints. Multivariate analysis identified the following variables as risk factors for pain intensity > 30/100 at one year: pre-operative PCS > 20/52 (OR = 3.5 ± 1.1 [95% CI: 1.9‒6.6]; p = 0.0001), trait-anxiety score ≥ 46 (OR = 2.4 ± 0.9 [95% CI: 1.1‒5.2]; p = 0.03), pre-operative pain ≥ 60/100 (OR = 3.2 ± 1 [95% CI: 1.8‒6.1]; p = 0.0001) and pain for at least 3 years (OR = 1.8 ± 0.6 [95% CI: 1‒3.4]; p = 0.04).

Conclusion

Pre-operative pain catastrophizing and trait-anxiety are risk factors for post-operative pain after shoulder, hip and knee arthroplasty.

Trial registration number

www.clinicaltrials.gov NCT02361359.



中文翻译:

疼痛灾难化和术前心理状态可预测髋关节、膝关节或肩关节置换术后的慢性疼痛:一年随访的前瞻性比较研究结果

目的

评估全肩、髋或膝关节置换术后一年术前心理状态、术后疼痛和功能之间的关系。

方法

纳入了 2014 年 3 月至 2015 年 11 月期间接受肩、髋或膝关节置换术的患者。疼痛灾难化评分 (PCS) 在术前、六个月和一年随访时确定。使用视觉模拟量表 (0‒100) 量化静息时的关节痛。使用贝克抑郁量表或老年抑郁评分测量抑郁症状,使用状态-特质量表测量情境焦虑和性格焦虑,并使用西安大略和麦克马斯特大学髋关节和膝关节骨关节炎指数以及牛津肩关节评分评估关节功能对于肩膀。

结果

总共包括 266 名患者(65% 为女性;平均 (± SD) 年龄:71.8 ± 10.3 岁;平均体重指数:27.5 ± 5.0 kg/m 2)。术前 PCS 与一年内 > 30/100 的疼痛以及所有关节的功能评分显着相关。多变量分析将以下变量确定为一年内疼痛强度 > 30/100 的风险因素:术前 PCS > 20/52(OR = 3.5 ± 1.1 [95% CI:1.9-6.6];p  = 0.0001),特征-焦虑评分 ≥ 46(OR = 2.4 ± 0.9 [95% CI:1.1-5.2];p  = 0.03),术前疼痛 ≥ 60/100(OR = 3.2 ± 1 [95% CI:1.8-6.1];p  = 0.0001) 和疼痛至少 3 年(OR = 1.8 ± 0.6 [95% CI:1-3.4];p  = 0.04)。

结论

术前疼痛灾难化和特质焦虑是肩、髋和膝关节置换术后疼痛的危险因素。

试用注册号

www.clinicaltrials.gov NCT02361359。

更新日期:2022-08-24
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