| Autor: |
Kosaku Aoyagi, Laura Frey Law, Lisa Carlesso, Michael Nevitt, Cora E. Lewis, Na Wang, Tuhina Neogi |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Osteoarthritis and Cartilage Open, Vol 5, Iss 1, Pp 100335- (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2665-9131 |
| DOI: |
10.1016/j.ocarto.2023.100335 |
| Popis: |
Objective: Pain persistence following knee replacement (KR) occurs in ∼20–30% of patients. Although several studies have identified preoperative risk factors for persistent post-KR pain, few have focused on post-KR contributing factors. We sought to determine whether altered nociceptive signaling and other peripheral nociceptive drivers present post-operatively contribute to post-KR pain. Design: We included participants from the Multicenter Osteoarthritis Study who were evaluated ∼12 months after KR. We evaluated the relation of measures of pain sensitivity [pressure pain threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM)] and the number of painful body sites to post-KR WOMAC knee pain, and of the number of painful sites to altered nociceptive signaling using linear or logistic regression models, as appropriate. Results: 171 participants (mean age 69 years, 62% female) were included. TS was associated with worse WOMAC pain post-KR (β = 0.77 95% CI:0.19–1.35) and reduced odds of achieving patient acceptable symptom state (aOR = 0.54 95%CI:0.34–0.88). Inefficient CPM was also associated with worse WOMAC pain post-KR (β = 1.43 95% CI:0.15–2.71). In contrast, PPT was not associated with these outcomes. The number of painful body sites present post-KR was associated with TS (β = 0.05, 95% CI:0.01, 0.05). Conclusions: Post-KR presence of central sensitization and inefficient descending pain modulation was associated with post-KR pain. We also noted that presence of other painful body sites contributes to altered nociceptive signaling, and this may thus also contribute to the experience of knee pain post-KR. Our findings provide novel insights into central pain mechanisms and other peripheral pain sources contributing to post-KR persistent knee pain. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
