Predictors of Persistent Post-Surgical Pain Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Observational Studies

被引：37

作者：

Ashoorion, Vahid ^{[1
]}

Sadeghirad, Behnam ^{[2
]}

Wang, Li ^{[3
,4
]}

Noori, Atefeh ^{[5
]}

Abdar, Meisam ^{[5
]}

Kim, Yechan ^{[6
]}

Chang, Yaping ^{[7
]}

Rehman, Nadia ^{[8
]}

Lopes, Luciane C. ^{[9
]}

Couban, Rachel J. ^{[10
]}

Aminilari, Mahmood ^{[5
]}

Malektojari, Alireza ^{[11
]}

Ghazizadeh, Sara ^{[11
]}

Rehman, Yasir ^{[8
,12
]}

Ghasemi, Mehdi ^{[13
]}

Adili, Anthony ^{[14
]}

Guyatt, Gordon H. ^{[5
]}

Busse, Jason W. ^{[15
,16
]}

机构：

[1] McMaster Univ, Michael G DeGroote Ctr Med Cannabis Res, Michael G DeGroote Natl Pain Ctr, Hamilton, ON, Canada

[2] McMaster Univ, Michael G DeGroote Natl Pain Ctr, Dept Anesthesia, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[3] McMaster Univ, Michael G DeGroote Natl Pain Ctr, Dept Anesthesia, Hamilton, ON, Canada

[4] Sichuan Univ, West China Hosp, Chinese Cochrane Ctr, Chengdu, Peoples R China

[5] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[6] Univ Western Ontario, Fac Med, London, ON, Canada

[7] OrthoEvidence, Burlington, ON, Canada

[8] Canadian Acad Osteopathy, Hamilton, ON, Canada

[9] Univ Sorocaba, Grad Program Pharmaceut Sci, Sorocaba, SP, Brazil

[10] McMaster Univ, Michael G DeGroote Natl Pain Ctr, Hamilton, ON, Canada

[11] Hormozgan Univ Med Sci, Bandarabbas, Iran

[12] McMaster Univ, Michael G DeGroote Natl Pain Ctr, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[13] Isfahan Univ Med Sci, Esfahan, Iran

[14] McMaster Univ, Dept Orthopaed Surg, Hamilton, ON, Canada

[15] McMaster Univ, Michael G DeGroote Ctr Med Cannabis Res, Michael G DeGroote Natl Pain Ctr, Dept Anesthesia,Dept Hlth Res Methods Evidence &, Hamilton, ON, Canada

[16] Chron Pain Ctr Excellence Canadian Vet, Hamilton, ON, Canada

来源：

PAIN MEDICINE | 2023年 / 24卷 / 04期

关键词：

Chronic Pain; Meta-Analysis; Prognosis; Risk Factors; Systematic Review; Total Knee Replacement; REVISION TOTAL KNEE; QUALITY-OF-LIFE; POSTOPERATIVE PAIN; TIBIAL COMPONENT; RADIOGRAPHIC SEVERITY; PROSPECTIVE COHORT; REPLACEMENT; OUTCOMES; OSTEOARTHRITIS; RISK;

D O I：

10.1093/pm/pnac154

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Objective Approximately one in four total knee replacement patients develop persistent pain. Identification of those at higher risk could help inform optimal management. Methods We searched MEDLINE, EMBASE, CINAHL, AMED, SPORTDiscus, and PsycINFO for observational studies that explored the association between risk factors and persistent pain (>= 3 months) after total knee replacement. We pooled estimates of association for all independent variables reported by >1 study. Results Thirty studies (26,517 patients) reported the association of 151 independent variables with persistent pain after knee replacement. High certainty evidence demonstrated an increased risk of persistent pain with pain catastrophizing (absolute risk increase [ARI] 23%, 95% confidence interval [CI] 12 to 35), younger age (ARI for every 10-year decrement from age 80, 4%, 95% CI 2 to 6), and moderate-to-severe acute post-operative pain (ARI 30%, 95% CI 20 to 39). Moderate certainty evidence suggested an association with female sex (ARI 7%, 95% CI 3 to 11) and higher pre-operative pain (ARI 35%, 95% CI 7 to 58). Studies did not adjust for both peri-operative pain severity and pain catastrophizing, which are unlikely to be independent. High to moderate certainty evidence demonstrated no association with pre-operative range of motion, body mass index, bilateral or unilateral knee replacement, and American Society of Anesthesiologists score. Conclusions Rigorously conducted observational studies are required to establish the relative importance of higher levels of peri-operative pain and pain catastrophizing with persistent pain after knee replacement surgery.

引用

页码：369 / 381

页数：13

共 81 条

[1] Total Knee Arthroplasty due to Knee Osteoarthritis: Risk Factors for Persistent Postsurgical Pain [J].