Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study

Abstract Background Few studies have evaluated the associations between preoperative factors and pain and physical function outcomes after total knee arthroplasty (TKA) from a mid-term perspective. Identification of such factors is important for optimizing outcomes following surgery. Thus, we examin...

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Main Authors: Unni Olsen, Vibeke Bull Sellevold, Caryl L. Gay, Arild Aamodt, Anners Lerdal, Milada Hagen, Alfhild Dihle, Maren Falch Lindberg
Format: Article
Language:English
Published: BMC 2024-01-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-023-07125-y
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author Unni Olsen
Vibeke Bull Sellevold
Caryl L. Gay
Arild Aamodt
Anners Lerdal
Milada Hagen
Alfhild Dihle
Maren Falch Lindberg
author_facet Unni Olsen
Vibeke Bull Sellevold
Caryl L. Gay
Arild Aamodt
Anners Lerdal
Milada Hagen
Alfhild Dihle
Maren Falch Lindberg
author_sort Unni Olsen
collection DOAJ
description Abstract Background Few studies have evaluated the associations between preoperative factors and pain and physical function outcomes after total knee arthroplasty (TKA) from a mid-term perspective. Identification of such factors is important for optimizing outcomes following surgery. Thus, we examined the associations between selected preoperative factors and moderate to severe pain and pain-related functional impairment as measured using the Brief Pain Inventory (BPI), five years after TKA in patients with knee osteoarthritis. Methods In this prospective observational study, all patients scheduled for primary unilateral TKA for osteoarthritis were consecutively recruited. Preoperative factors identified from previous meta-analyses were included to assess their associations with pain severity and pain-related functional impairment five years after TKA. Pain severity was the primary outcome, while pain-related functional impairment was the secondary outcome. The BPI was used to evaluate outcomes five years post-TKA. Statistically significant factors from univariate regressions were entered into a multiple logistic regression model to identify those with the strongest associations with pain severity or pain-related functional impairment five years after TKA. Results A total of 136 patients were included, with a mean age of 67.7 years (SD 9.2) and a majority being female (68%). More severe preoperative pain (OR = 1.34, 95% CI [1.03 to 1.74]), more painful sites (OR = 1.28., 95% CI [1.01 to 1.63]), and more severe anxiety symptoms (OR = 1.14., 95% CI [1.01 to 1.28]) were associated with increased likelihood of moderate to severe pain five years after TKA surgery, while more severe osteoarthritis (OR = 0.13, 95% CI [0.03 to 0.61]) was associated with reduced likelihood of moderate to severe pain five years after TKA. More severe anxiety symptoms (OR = 1.25, 95% CI [1.08 to 1.46]) were also associated with increased likelihood of moderate to severe pain-related functional impairment five years after surgery, while male sex (OR = 0.23, 95% CI [0.05 to 0.98]) was associated with reduced likelihood of pain-related functional impairment five years after surgery. Conclusion The identified preoperative factors should be included in larger prognostic studies evaluating the associations between preoperative factors and mid-term pain severity and physical function outcomes after TKA surgery.
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spelling doaj.art-e51a94d9b5d94d15a67094d3fc06cd582024-01-07T12:04:16ZengBMCBMC Musculoskeletal Disorders1471-24742024-01-0125111010.1186/s12891-023-07125-yFactors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational studyUnni Olsen0Vibeke Bull Sellevold1Caryl L. Gay2Arild Aamodt3Anners Lerdal4Milada Hagen5Alfhild Dihle6Maren Falch Lindberg7Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of OsloLovisenberg Diaconal University CollegeDepartment of Family Health Care Nursing, University of CaliforniaDepartment of Orthopaedic Surgery, Lovisenberg Diaconal HospitalResearch Department, Lovisenberg Diaconal HospitalFaculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan UniversityFaculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan UniversityDepartment of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of OsloAbstract Background Few studies have evaluated the associations between preoperative factors and pain and physical function outcomes after total knee arthroplasty (TKA) from a mid-term perspective. Identification of such factors is important for optimizing outcomes following surgery. Thus, we examined the associations between selected preoperative factors and moderate to severe pain and pain-related functional impairment as measured using the Brief Pain Inventory (BPI), five years after TKA in patients with knee osteoarthritis. Methods In this prospective observational study, all patients scheduled for primary unilateral TKA for osteoarthritis were consecutively recruited. Preoperative factors identified from previous meta-analyses were included to assess their associations with pain severity and pain-related functional impairment five years after TKA. Pain severity was the primary outcome, while pain-related functional impairment was the secondary outcome. The BPI was used to evaluate outcomes five years post-TKA. Statistically significant factors from univariate regressions were entered into a multiple logistic regression model to identify those with the strongest associations with pain severity or pain-related functional impairment five years after TKA. Results A total of 136 patients were included, with a mean age of 67.7 years (SD 9.2) and a majority being female (68%). More severe preoperative pain (OR = 1.34, 95% CI [1.03 to 1.74]), more painful sites (OR = 1.28., 95% CI [1.01 to 1.63]), and more severe anxiety symptoms (OR = 1.14., 95% CI [1.01 to 1.28]) were associated with increased likelihood of moderate to severe pain five years after TKA surgery, while more severe osteoarthritis (OR = 0.13, 95% CI [0.03 to 0.61]) was associated with reduced likelihood of moderate to severe pain five years after TKA. More severe anxiety symptoms (OR = 1.25, 95% CI [1.08 to 1.46]) were also associated with increased likelihood of moderate to severe pain-related functional impairment five years after surgery, while male sex (OR = 0.23, 95% CI [0.05 to 0.98]) was associated with reduced likelihood of pain-related functional impairment five years after surgery. Conclusion The identified preoperative factors should be included in larger prognostic studies evaluating the associations between preoperative factors and mid-term pain severity and physical function outcomes after TKA surgery.https://doi.org/10.1186/s12891-023-07125-yKnee arthroplastyPainChronic painFunctionOsteoarthritisPrognosis
spellingShingle Unni Olsen
Vibeke Bull Sellevold
Caryl L. Gay
Arild Aamodt
Anners Lerdal
Milada Hagen
Alfhild Dihle
Maren Falch Lindberg
Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
BMC Musculoskeletal Disorders
Knee arthroplasty
Pain
Chronic pain
Function
Osteoarthritis
Prognosis
title Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
title_full Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
title_fullStr Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
title_full_unstemmed Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
title_short Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
title_sort factors associated with pain and functional impairment five years after total knee arthroplasty a prospective observational study
topic Knee arthroplasty
Pain
Chronic pain
Function
Osteoarthritis
Prognosis
url https://doi.org/10.1186/s12891-023-07125-y
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