Skip to main content
Top
Published in: International Orthopaedics 12/2019

01-12-2019 | Knee-TEP | Original Paper

Social determinants associated to chronic pain after total knee arthroplasty

Authors: Rodrigo Núñez-Cortés, Claudio Chamorro, Maritza Ortega-Palavecinos, Gustavo Mattar, Orlando Paredes, Álvaro Besoaín-Saldaña, Carlos Cruz-Montecinos

Published in: International Orthopaedics | Issue 12/2019

Login to get access

Abstract

Aim of the study

Analyze the association between social health determinants (SHD) and chronic post-surgical pain (CPSP) after total knee arthroplasty (TKA).

Method

A cross-sectional study was performed in 58 TKA patients. The subjects were classified in two groups: with (n = 22) or without (n = 36) CPSP. SHD considered were gender, age, educational level, economic income, and labour conditions.

Results

Significant differences were found concerning educational level when comparing subjects with or without CPSP, with a low educational level of 22.4% and 19%, respectively. 15.5% of patients with persistent pain had a high educational level compared with 43.1% of the patients without persistent pain (p = 0.032). No significant differences were found for the other categories (p > 0.05). The odds ratio (95% confidence interval) was 3.28 (1.09–9.93) for lower educational level compared with high educational level.

Discussion

CPSP must be considered a severe health problem. In addition to SDH, there are multiple factors associated with chronic pain after TKA that must be considered for an effective treatment.

Conclusions

Patients with lower educational level showed a three-time higher association to develop CPSP. Considering SHD could be of relevance when elaborating new interventions or health strategies and more specialized counseling for patients with persistent pain after TKA.
Literature
1.
go back to reference Brander VA, Stulberg SD, Adams AD, et al (2003) Predicting total knee replacement pain: a prospective, observational study. Clin Orthop Relat Res 27–36 Brander VA, Stulberg SD, Adams AD, et al (2003) Predicting total knee replacement pain: a prospective, observational study. Clin Orthop Relat Res 27–36
3.
go back to reference Gaweł J, Fibiger W, Starowicz A, Szwarczyk W (2010) Early assessment of knee function and quality of life in patients after total knee replacement. Ortop Traumatol Rehabil 12:329–337PubMed Gaweł J, Fibiger W, Starowicz A, Szwarczyk W (2010) Early assessment of knee function and quality of life in patients after total knee replacement. Ortop Traumatol Rehabil 12:329–337PubMed
4.
go back to reference Chodór P, Kruczyński J (2016) Predicting persistent unclear pain following primary total knee arthroplasty. Ortop Traumatol Rehabil 18:527–536PubMed Chodór P, Kruczyński J (2016) Predicting persistent unclear pain following primary total knee arthroplasty. Ortop Traumatol Rehabil 18:527–536PubMed
5.
go back to reference Wylde V, Bruce J, Beswick A et al (2013) Assessment of chronic postsurgical pain after knee replacement: a systematic review. Arthritis Care Res 65:1795–1803 Wylde V, Bruce J, Beswick A et al (2013) Assessment of chronic postsurgical pain after knee replacement: a systematic review. Arthritis Care Res 65:1795–1803
6.
go back to reference Vergne-Salle P (2016) Management of neuropathic pain after knee surgery. Joint Bone Spine 83:657–663PubMed Vergne-Salle P (2016) Management of neuropathic pain after knee surgery. Joint Bone Spine 83:657–663PubMed
7.
go back to reference Kurtz SM, Ong KL, Lau E, Bozic KJ (2014) Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021. J Bone Joint Surg Am 96:624–630PubMed Kurtz SM, Ong KL, Lau E, Bozic KJ (2014) Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021. J Bone Joint Surg Am 96:624–630PubMed
8.
go back to reference Grosu I, Lavand’homme P, Thienpont E (2014) Pain after knee arthroplasty: an unresolved issue. Knee Surg Sports Traumatol Arthrosc 22:1744–1758PubMed Grosu I, Lavand’homme P, Thienpont E (2014) Pain after knee arthroplasty: an unresolved issue. Knee Surg Sports Traumatol Arthrosc 22:1744–1758PubMed
9.
go back to reference Núñez-Cortés R, Cruz-Montecinos C, Vásquez-Rosel Á et al (2017) Dry needling combined with physical therapy in patients with chronic postsurgical pain following total knee arthroplasty: a case series. J Orthop Sports Phys Ther 47:209–216PubMed Núñez-Cortés R, Cruz-Montecinos C, Vásquez-Rosel Á et al (2017) Dry needling combined with physical therapy in patients with chronic postsurgical pain following total knee arthroplasty: a case series. J Orthop Sports Phys Ther 47:209–216PubMed
10.
go back to reference Bossmann T, Brauner T, Wearing S, Horstmann T (2017) Predictors of chronic pain following total knee replacement in females and males: an exploratory study. Pain Manag 7:391–403PubMed Bossmann T, Brauner T, Wearing S, Horstmann T (2017) Predictors of chronic pain following total knee replacement in females and males: an exploratory study. Pain Manag 7:391–403PubMed
11.
go back to reference Lewis GN, Rice DA, McNair PJ, Kluger M (2015) Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis. Br J Anaesth 114:551–561PubMed Lewis GN, Rice DA, McNair PJ, Kluger M (2015) Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis. Br J Anaesth 114:551–561PubMed
12.
go back to reference Wylde V, Hewlett S, Learmonth ID, Dieppe P (2011) Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain 152:566–572PubMed Wylde V, Hewlett S, Learmonth ID, Dieppe P (2011) Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain 152:566–572PubMed
13.
go back to reference Ip HYV, Abrishami A, Peng PWH et al (2009) Predictors of postoperative pain and analgesic consumption. Anesthesiology 111:657–677PubMed Ip HYV, Abrishami A, Peng PWH et al (2009) Predictors of postoperative pain and analgesic consumption. Anesthesiology 111:657–677PubMed
14.
go back to reference Bierke S, Petersen W (2017) Influence of anxiety and pain catastrophizing on the course of pain within the first year after uncomplicated total knee replacement: a prospective study. Arch Orthop Trauma Surg 137:1735–1742PubMed Bierke S, Petersen W (2017) Influence of anxiety and pain catastrophizing on the course of pain within the first year after uncomplicated total knee replacement: a prospective study. Arch Orthop Trauma Surg 137:1735–1742PubMed
15.
go back to reference Lindner M, Nosseir O, Keller-Pliessnig A et al (2018) Psychosocial predictors for outcome after total joint arthroplasty: a prospective comparison of hip and knee arthroplasty. BMC Musculoskelet Disord 19:159PubMedPubMedCentral Lindner M, Nosseir O, Keller-Pliessnig A et al (2018) Psychosocial predictors for outcome after total joint arthroplasty: a prospective comparison of hip and knee arthroplasty. BMC Musculoskelet Disord 19:159PubMedPubMedCentral
16.
go back to reference Roth ML, Tripp DA, Harrison MH et al (2007) Demographic and psychosocial predictors of acute perioperative pain for total knee arthroplasty. Pain Res Manag 12:185–194PubMedPubMedCentral Roth ML, Tripp DA, Harrison MH et al (2007) Demographic and psychosocial predictors of acute perioperative pain for total knee arthroplasty. Pain Res Manag 12:185–194PubMedPubMedCentral
17.
go back to reference Marmot M, Friel S, Bell R et al (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 372:1661–1669PubMed Marmot M, Friel S, Bell R et al (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 372:1661–1669PubMed
18.
go back to reference Solar O, Irwin A (2006) Social determinants, political contexts and civil society action: a historical perspective on the commission on social determinants of health. Health Promot J Austr 17:180–185PubMed Solar O, Irwin A (2006) Social determinants, political contexts and civil society action: a historical perspective on the commission on social determinants of health. Health Promot J Austr 17:180–185PubMed
19.
20.
go back to reference Fliesser M, De Witt Huberts J, Wippert P-M (2017) The choice that matters: the relative influence of socioeconomic status indicators on chronic back pain- a longitudinal study. BMC Health Serv Res 17:800PubMedPubMedCentral Fliesser M, De Witt Huberts J, Wippert P-M (2017) The choice that matters: the relative influence of socioeconomic status indicators on chronic back pain- a longitudinal study. BMC Health Serv Res 17:800PubMedPubMedCentral
21.
go back to reference Zarei S, Bigizadeh S, Pourahmadi M, Ghobadifar MA (2012) Chronic pain and its determinants: a population-based study in Southern Iran. Korean J Pain 25:245–253PubMedPubMedCentral Zarei S, Bigizadeh S, Pourahmadi M, Ghobadifar MA (2012) Chronic pain and its determinants: a population-based study in Southern Iran. Korean J Pain 25:245–253PubMedPubMedCentral
22.
go back to reference Allen Butler R, Rosenzweig S, Myers L, Barrack RL (2011) The Frank Stinchfield Award: the impact of socioeconomic factors on outcome after THA: a prospective, randomized study. Clin Orthop Relat Res 469:339–347PubMed Allen Butler R, Rosenzweig S, Myers L, Barrack RL (2011) The Frank Stinchfield Award: the impact of socioeconomic factors on outcome after THA: a prospective, randomized study. Clin Orthop Relat Res 469:339–347PubMed
23.
go back to reference Goodman SM, Mandl LA, Mehta B et al (2018) Does education level mitigate the effect of poverty on total knee arthroplasty outcomes? Arthritis Care Res 70:884–891 Goodman SM, Mandl LA, Mehta B et al (2018) Does education level mitigate the effect of poverty on total knee arthroplasty outcomes? Arthritis Care Res 70:884–891
24.
go back to reference Jensen MP, Chen C, Brugger AM (2002) Postsurgical pain outcome assessment. Pain 99:101–109PubMed Jensen MP, Chen C, Brugger AM (2002) Postsurgical pain outcome assessment. Pain 99:101–109PubMed
25.
go back to reference Roth RS, Geisser ME (2002) Educational achievement and chronic pain disability: mediating role of pain-related cognitions. Clin J Pain 18:286–296PubMed Roth RS, Geisser ME (2002) Educational achievement and chronic pain disability: mediating role of pain-related cognitions. Clin J Pain 18:286–296PubMed
26.
go back to reference Barrack RL, Ruh EL, Chen J et al (2014) Impact of socioeconomic factors on outcome of total knee arthroplasty. Clin Orthop Relat Res 472:86–97PubMed Barrack RL, Ruh EL, Chen J et al (2014) Impact of socioeconomic factors on outcome of total knee arthroplasty. Clin Orthop Relat Res 472:86–97PubMed
27.
go back to reference Santaguida PL, Hawker GA, Hudak PL et al (2008) Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg 51:428–436PubMedPubMedCentral Santaguida PL, Hawker GA, Hudak PL et al (2008) Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg 51:428–436PubMedPubMedCentral
28.
go back to reference Elson DW, Brenkel IJ (2006) Predicting pain after total knee arthroplasty. J Arthroplast 21:1047–1053 Elson DW, Brenkel IJ (2006) Predicting pain after total knee arthroplasty. J Arthroplast 21:1047–1053
29.
go back to reference O’Connor MI (2011) Implant survival, knee function, and pain relief after TKA: are there differences between men and women? Clin Orthop Relat Res 469:1846–1851PubMedPubMedCentral O’Connor MI (2011) Implant survival, knee function, and pain relief after TKA: are there differences between men and women? Clin Orthop Relat Res 469:1846–1851PubMedPubMedCentral
30.
go back to reference Fuzier R, Serres I, Bourrel R et al (2014) Analgesic drug consumption increases after knee arthroplasty: a pharmacoepidemiological study investigating postoperative pain. Pain 155:1339–1345PubMed Fuzier R, Serres I, Bourrel R et al (2014) Analgesic drug consumption increases after knee arthroplasty: a pharmacoepidemiological study investigating postoperative pain. Pain 155:1339–1345PubMed
31.
go back to reference Vogel M, Riediger C, Krippl M et al (2019) Negative affect, type D personality, quality of life, and dysfunctional outcomes of total knee arthroplasty. Pain Res Manag 2019:6393101PubMedPubMedCentral Vogel M, Riediger C, Krippl M et al (2019) Negative affect, type D personality, quality of life, and dysfunctional outcomes of total knee arthroplasty. Pain Res Manag 2019:6393101PubMedPubMedCentral
33.
go back to reference Cremeans-Smith JK, Greene K, Delahanty DL (2016) Physiological indices of stress prior to and following total knee arthroplasty predict the occurrence of severe post-operative pain. Pain Med 17:970–979PubMed Cremeans-Smith JK, Greene K, Delahanty DL (2016) Physiological indices of stress prior to and following total knee arthroplasty predict the occurrence of severe post-operative pain. Pain Med 17:970–979PubMed
34.
go back to reference Filbay SR, Judge A, Delmestri A et al (2018) Evaluating patients’ expectations from a novel patient-centered perspective predicts knee arthroplasty outcome. J Arthroplast 33:2146–2152.e4 Filbay SR, Judge A, Delmestri A et al (2018) Evaluating patients’ expectations from a novel patient-centered perspective predicts knee arthroplasty outcome. J Arthroplast 33:2146–2152.e4
35.
36.
go back to reference Calatayud J, Casaña J, Ezzatvar Y et al (2017) High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 25:2864–2872PubMed Calatayud J, Casaña J, Ezzatvar Y et al (2017) High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 25:2864–2872PubMed
37.
go back to reference Koh IJ, Kim MS, Sohn S et al (2019) Duloxetine reduces pain and improves quality of recovery following total knee arthroplasty in centrally sensitized patients: a prospective, randomized controlled study. J Bone Joint Surg Am 101:64–73PubMed Koh IJ, Kim MS, Sohn S et al (2019) Duloxetine reduces pain and improves quality of recovery following total knee arthroplasty in centrally sensitized patients: a prospective, randomized controlled study. J Bone Joint Surg Am 101:64–73PubMed
38.
go back to reference Monticone M, Ferrante S, Rocca B et al (2013) Home-based functional exercises aimed at managing kinesiophobia contribute to improving disability and quality of life of patients undergoing total knee arthroplasty: a randomized controlled trial. Arch Phys Med Rehabil 94:231–239PubMed Monticone M, Ferrante S, Rocca B et al (2013) Home-based functional exercises aimed at managing kinesiophobia contribute to improving disability and quality of life of patients undergoing total knee arthroplasty: a randomized controlled trial. Arch Phys Med Rehabil 94:231–239PubMed
39.
40.
go back to reference Motififard M, Omidian A, Badiei S (2017) Pre-emptive injection of peri-articular-multimodal drug for post-operative pain management in total knee arthroplasty: a double-blind randomized clinical trial. Int Orthop 41:939–947PubMed Motififard M, Omidian A, Badiei S (2017) Pre-emptive injection of peri-articular-multimodal drug for post-operative pain management in total knee arthroplasty: a double-blind randomized clinical trial. Int Orthop 41:939–947PubMed
41.
go back to reference Li D, Tan Z, Kang P et al (2017) Effects of multi-site infiltration analgesia on pain management and early rehabilitation compared with femoral nerve or adductor canal block for patients undergoing total knee arthroplasty: a prospective randomized controlled trial. Int Orthop 41:75–83PubMed Li D, Tan Z, Kang P et al (2017) Effects of multi-site infiltration analgesia on pain management and early rehabilitation compared with femoral nerve or adductor canal block for patients undergoing total knee arthroplasty: a prospective randomized controlled trial. Int Orthop 41:75–83PubMed
42.
go back to reference Danninger T, Opperer M, Memtsoudis SG (2014) Perioperative pain control after total knee arthroplasty: an evidence based review of the role of peripheral nerve blocks. World J Orthop 5:225–232PubMedPubMedCentral Danninger T, Opperer M, Memtsoudis SG (2014) Perioperative pain control after total knee arthroplasty: an evidence based review of the role of peripheral nerve blocks. World J Orthop 5:225–232PubMedPubMedCentral
43.
go back to reference Dueñas M, Ojeda B, Salazar A et al (2016) A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res 9:457–446PubMedPubMedCentral Dueñas M, Ojeda B, Salazar A et al (2016) A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res 9:457–446PubMedPubMedCentral
Metadata
Title
Social determinants associated to chronic pain after total knee arthroplasty
Authors
Rodrigo Núñez-Cortés
Claudio Chamorro
Maritza Ortega-Palavecinos
Gustavo Mattar
Orlando Paredes
Álvaro Besoaín-Saldaña
Carlos Cruz-Montecinos
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Keywords
Knee-TEP
Knee-TEP
Published in
International Orthopaedics / Issue 12/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-019-04370-6

Other articles of this Issue 12/2019

International Orthopaedics 12/2019 Go to the issue