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Observational Study
. 2022 Apr;42(4):689-698.
doi: 10.1007/s00296-022-05094-4. Epub 2022 Feb 26.

Acute pain after total hip and knee arthroplasty does not affect chronic pain during the first postoperative year: observational cohort study of 389 patients

D A J M Latijnhouwers  1 , C H Martini  2 , R G H H Nelissen  3 , S H M Verdegaal  4 , T P M Vliet Vlieland  5 , M G J Gademan  3   6 ; Longitudinal Leiden Orthopaedics Outcomes of Osteoarthritis Study (LOAS) Group
Collaborators, Affiliations
Observational Study

Acute pain after total hip and knee arthroplasty does not affect chronic pain during the first postoperative year: observational cohort study of 389 patients

D A J M Latijnhouwers et al. Rheumatol Int. 2022 Apr.

Abstract

Chronic pain is frequently reported after total hip and knee arthroplasties (THA/TKA) in osteoarthritis (OA) patients. We investigated if severity of acute postoperative pain following THA/TKA in OA patients was associated with pain during the first postoperative year. From an observational study, OA patients scheduled for primary THA/TKA (June 2012-December 2017) were included from two hospitals in the Netherlands. Acute postoperative pain scores were collected within 72 h postoperatively and categorized as no/mild (NRS ≤ 4) or moderate/severe (NRS > 4). Pain was assessed preoperatively, 3, 6 and 12 months postoperatively using the HOOS/KOOS subscale pain. With Multilevel Mixed-effects-analyses, we estimated associations between acute and chronic pain until one year postoperative, adjusted for confounders and including an interaction term (Time*Acute pain). 193 THA and 196 TKA patients were included, 29% of THA and 51% of TKA patients reported moderate/severe pain acutely after surgery. In the THA group, the difference in pain at 3 months between the no/mild and moderate/severe groups, was approximately six points, in favor of the no/mild group (95% CI [-12.4 to 0.9]) this difference became smaller over time. In the TKA group we found similar differences, with approximately four points (95% CI [-9.6 to 1.3]) difference between the no/mild and moderate/severe group at 6 months, this difference attenuated at 12 months. No association between severity of acute postoperative pain and pain during the first postoperative year was found. These findings suggest that measures to limit acute postoperative pain will likely not impact development of chronic pain.

Keywords: Acute; Arthroplasty; Chronic; Hip; Knee; Pain.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of included total hip and knee arthroplasty patients. THA Total Hip Arthroplasty, TKA Total Knee Arthroplasty
Fig. 2
Fig. 2
A HOOS pain scores at 3, 6 and 12 months postoperatively in Total Hip Arthroplasty patients reporting mild or severe acute pain (0 = extreme pain, 100 = no pain) (n = 83). HOOS Hip disability and Osteoarthritis Outcome Score. B KOOS pain scores at 6 and 12 months postoperatively in Total Knee Arthroplasty patients reporting mild or severe acute pain (0 = extreme pain, 100 = no pain) (n = 148). KOOS Knee injury and Osteoarthritis Outcome Score
See this image and copyright information in PMC

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