TY - JOUR
T1 - Prognostics for pain in osteoarthritis
T2 - Do clinical measures predict pain after total joint replacement?
AU - Barroso, Joana
AU - Wakaizumi, Kenta
AU - Reckziegel, Diane
AU - Pinto-Ramos, João
AU - Schnitzer, Thomas
AU - Galhardo, Vasco
AU - Apkarian, A. Vania
N1 - Funding Information:
J.B. was funded through CCDRN [Norte- 08-5369-FSE-000026], OARSI Collaborative Scholarship 2018 and Luso-American Development Foundation R&D@PhD scholarship grant. This research did not receive other specific funding from agencies in the public or commercial sectors*%blankline%**%blankline%*
Publisher Copyright:
© 2020 Public Library of Science. All rights reserved.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - A significant proportion of osteoarthritis (OA) patients continue to experience moderate to severe pain after total joint replacement (TJR). Preoperative factors related to pain persistence are mainly studied using individual predictor variables and distinct pain outcomes, thus leading to a lack of consensus regarding the influence of preoperative parameters on post-TJR pain. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models and network analysis were applied to pain related biopsychosocial measures and their changes with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Although distinct pain scales were associated with different aspects of post-surgical pain, multi-factorial models did not reliably predict post-surgical pain in knee OA (across four distinct pain scales) and did not generalize to hip OA. However, network analysis showed significant changes in biopsychosocial-defined OA personality post-surgery, in both groups. Our results show that although tested clinical and biopsychosocial variables reorganize after TJR in OA, their presurgical values are not predictive of post-surgery pain. Derivation of prognostic markers for pain persistence after TJR will require more comprehensive understanding of underlying mechanisms.
AB - A significant proportion of osteoarthritis (OA) patients continue to experience moderate to severe pain after total joint replacement (TJR). Preoperative factors related to pain persistence are mainly studied using individual predictor variables and distinct pain outcomes, thus leading to a lack of consensus regarding the influence of preoperative parameters on post-TJR pain. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models and network analysis were applied to pain related biopsychosocial measures and their changes with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Although distinct pain scales were associated with different aspects of post-surgical pain, multi-factorial models did not reliably predict post-surgical pain in knee OA (across four distinct pain scales) and did not generalize to hip OA. However, network analysis showed significant changes in biopsychosocial-defined OA personality post-surgery, in both groups. Our results show that although tested clinical and biopsychosocial variables reorganize after TJR in OA, their presurgical values are not predictive of post-surgery pain. Derivation of prognostic markers for pain persistence after TJR will require more comprehensive understanding of underlying mechanisms.
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U2 - 10.1371/journal.pone.0222370
DO - 10.1371/journal.pone.0222370
M3 - Article
C2 - 31914126
AN - SCOPUS:85077751716
VL - 15
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 1
M1 - e0222370
ER -