Systematic Reviews
Copyright ©The Author(s) 2015.
World J Orthop. Aug 18, 2015; 6(7): 528-536
Published online Aug 18, 2015. doi: 10.5312/wjo.v6.i7.528
Table 3 Studies including total knee replacement patients concerning the prevalence and etiology of neuropathic pain
Ref.DesignNo. of patientsAim of the studyScores-scalesFollow-upPainFactors
Wylde et al[9]Retrospective632To assess: (1) prevalence; (2) severity; (3) sensory qualities; and (4) postoperative determinants of persistent pain after primary THR and TKRWestern Ontario and McMaster Universities Index of Osteoarthritis Pain Scale Short-Form McGill Pain Questionnaire PainDETECT Questionnaire Two-item Patient Health QuestionnaireMedian: 41 mo Range: 34-49 moPPSP: 44% Severe-extreme PPSP: 15% Constant PPSP: 5% Likely NP: 6%Significant and independent postoperative determinants of number of PPSP: (1) No. of pain problems elsewhere; and (2) The presence of major depression
Masselin-Dubois et al[31]ProspectiveTKR patients: 89 breast cancer surgery patients: 100To assess the predictive value of: (1) Anxiety; (2) Depression; (3) Pain catastrophizing; and (4) Baseline pain intensity for chronic post-surgical pain. The existence of neuropathic painBPI NRS Neuropathic Pain Diagnostic Questionnaire (DN4) Spielberger STAI 13-item BDI PCSPre-op. Post-op: (1) 2 d (2) 3 moTKR patients: (1) Pre-op: 84% at least moderate pain (2) 2 d: 46.9%; and (3) 3 mo: 50.6% Neuropathic pain TKR patients: (1) Pre-op: 30.7% (2) 3 mo: 42.2%Regardless the type of surgery, state anxiety, pain catastrophizing (especially pain magnification) and acute post-surgical pain are predictive of persistent post-surgical pain Acute post-surgical pain was also predictive of NP pain. Baseline pain intensity, trait anxiety and depression had no independent impact on post-surgical pain (considering low baseline scores for depression in this study)
Lavand’homme et al[33]ProspectiveTKR and UKR patients: 120To examine the relationship between postoperative pain trajectories and persistent pain, specifically neuropathic pain.NRS Neuropathic Pain Diagnostic Questionnaire (DN4) PCS Spielberger STAI for AdultsPre-op. Post-op: (1) Day 1 to day 8; (2) 3 moAt 3 mo post-op: (1) 42% patients were pain free (2) 47% patients with persistent pain without NP pain; and (3) 11% patients with persistent pain involving neuropathic componentPatients with neuropathic pain displayed higher pain scores, particularly during mobilization No differences found among pain trajectories for pain at rest
Attal et al[32]ProspectiveTKR patients: 89 breast cancer surgery patients: 100If: (1) cognitive functioning (2) emotional functioning and pain coping are predictors of persistent post-surgical pain and neuropathic painBPI Neuropathic Pain Diagnostic Questionnaire (DN4) TMT A TMT B ROCF-copy ROCF-immediate recall BDI Spielberger STAI CSQ Brief Version of the SOPA-BPre-op: (1) 1 mo; and (2) 1 d Post-op: (1) 2 d; (2) 6 mo, 12 moTKR patients (1) Pre-op: 84%; (2) 6 mo: 39%; and (3) 12 mo: 38% Neuropathic pain TKR patients: (1) Pre-op: 75 patients; (2) 6 mo: 32 patients; and (3) 12 mo: 26 patientsCognitive functioning, emotional functioning and pain coping made an independent contribution to the prevalence and severity of persistent post-surgical pain, as well as its neuropathic quality. Results at ROCF-copy and ROCF- immediate recall test seemed to be predictors of pain with neuropathic nature