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Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis
MAIN OBJECTIVE: Systematically review and synthesize preoperative and intraoperative factors associated with pain after total knee arthroplasty (TKA) in patients with osteoarthritis. METHODS: Based on a peer-reviewed protocol, we searched Medline, Embase, CINAHL, Cochrane Library, and PEDro for pros...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038299/ https://www.ncbi.nlm.nih.gov/pubmed/36961863 http://dx.doi.org/10.1371/journal.pone.0283446 |
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author | Olsen, Unni Lindberg, Maren Falch Rose, Christopher Denison, Eva Gay, Caryl Aamodt, Arild Brox, Jens Ivar Skare, Øystein Furnes, Ove Lee, Kathryn A. Lerdal, Anners |
author_facet | Olsen, Unni Lindberg, Maren Falch Rose, Christopher Denison, Eva Gay, Caryl Aamodt, Arild Brox, Jens Ivar Skare, Øystein Furnes, Ove Lee, Kathryn A. Lerdal, Anners |
author_sort | Olsen, Unni |
collection | PubMed |
description | MAIN OBJECTIVE: Systematically review and synthesize preoperative and intraoperative factors associated with pain after total knee arthroplasty (TKA) in patients with osteoarthritis. METHODS: Based on a peer-reviewed protocol, we searched Medline, Embase, CINAHL, Cochrane Library, and PEDro for prospective observational studies (January 2000 to February 2023) investigating factors associated with pain after TKA. The primary outcome was pain twelve months after TKA. Pain at three and six months were secondary outcomes. Multivariate random-effects meta-analyses were used to estimate mean correlation (95% CIs) between factors and pain. Sensitivity analysis was performed for each risk of bias domain and certainty of evidence was assessed. RESULTS: Of 13,640 studies, 29 reports of 10,360 patients and 61 factors were analysed. The mean correlation between preoperative factors and more severe pain at twelve months was estimated to be 0.36 (95% CI, 0.24, 0.47; P < .000; moderate-certainty evidence) for more catastrophizing, 0.15 (95% CI; 0.08, 0.23; P < .001; moderate-certainty evidence) for more symptomatic joints, 0.13 (95% CI, 0.06, 0.19; P < .001; very low-certainty evidence) for more preoperative pain. Mean correlation between more severe radiographic osteoarthritis and less pain was -0.15 (95% CI; -0.23, -0.08; P < .001; low-certainty evidence). In sensitivity analysis, the estimated correlation coefficient for pain catastrophizing factor increased to 0.38 (95% CI 0.04, 0.64). At six and three months, more severe preoperative pain was associated with more pain. Better preoperative mental health was associated with less pain at six months. CONCLUSION AND RELEVANCE: More pain catastrophizing, more symptomatic joints and more pain preoperatively were correlated with more pain, while more severe osteoarthritis was correlated with less pain one year after TKA. More preoperative pain was correlated with more pain, and better mental health with less pain at six and three months. These findings should be further tested in predictive models to gain knowledge which may improve TKA outcomes. |
format | Online Article Text |
id | pubmed-10038299 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100382992023-03-25 Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis Olsen, Unni Lindberg, Maren Falch Rose, Christopher Denison, Eva Gay, Caryl Aamodt, Arild Brox, Jens Ivar Skare, Øystein Furnes, Ove Lee, Kathryn A. Lerdal, Anners PLoS One Research Article MAIN OBJECTIVE: Systematically review and synthesize preoperative and intraoperative factors associated with pain after total knee arthroplasty (TKA) in patients with osteoarthritis. METHODS: Based on a peer-reviewed protocol, we searched Medline, Embase, CINAHL, Cochrane Library, and PEDro for prospective observational studies (January 2000 to February 2023) investigating factors associated with pain after TKA. The primary outcome was pain twelve months after TKA. Pain at three and six months were secondary outcomes. Multivariate random-effects meta-analyses were used to estimate mean correlation (95% CIs) between factors and pain. Sensitivity analysis was performed for each risk of bias domain and certainty of evidence was assessed. RESULTS: Of 13,640 studies, 29 reports of 10,360 patients and 61 factors were analysed. The mean correlation between preoperative factors and more severe pain at twelve months was estimated to be 0.36 (95% CI, 0.24, 0.47; P < .000; moderate-certainty evidence) for more catastrophizing, 0.15 (95% CI; 0.08, 0.23; P < .001; moderate-certainty evidence) for more symptomatic joints, 0.13 (95% CI, 0.06, 0.19; P < .001; very low-certainty evidence) for more preoperative pain. Mean correlation between more severe radiographic osteoarthritis and less pain was -0.15 (95% CI; -0.23, -0.08; P < .001; low-certainty evidence). In sensitivity analysis, the estimated correlation coefficient for pain catastrophizing factor increased to 0.38 (95% CI 0.04, 0.64). At six and three months, more severe preoperative pain was associated with more pain. Better preoperative mental health was associated with less pain at six months. CONCLUSION AND RELEVANCE: More pain catastrophizing, more symptomatic joints and more pain preoperatively were correlated with more pain, while more severe osteoarthritis was correlated with less pain one year after TKA. More preoperative pain was correlated with more pain, and better mental health with less pain at six and three months. These findings should be further tested in predictive models to gain knowledge which may improve TKA outcomes. Public Library of Science 2023-03-24 /pmc/articles/PMC10038299/ /pubmed/36961863 http://dx.doi.org/10.1371/journal.pone.0283446 Text en © 2023 Olsen et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Olsen, Unni Lindberg, Maren Falch Rose, Christopher Denison, Eva Gay, Caryl Aamodt, Arild Brox, Jens Ivar Skare, Øystein Furnes, Ove Lee, Kathryn A. Lerdal, Anners Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis |
title | Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis |
title_full | Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis |
title_fullStr | Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis |
title_full_unstemmed | Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis |
title_short | Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis |
title_sort | factors correlated with pain after total knee arthroplasty: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038299/ https://www.ncbi.nlm.nih.gov/pubmed/36961863 http://dx.doi.org/10.1371/journal.pone.0283446 |
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