Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements

OBJECTIVE: There is limited information about the extent to which the association between preoperative and chronic postoperative pain is mediated via pain‐on‐movement or pain‐at‐rest. We explored these associations in patients undergoing total hip replacement (THR) and total knee replacement (TKR)....

Descripción completa

Detalles Bibliográficos
Autores principales: Sayers, Adrian, Wylde, Vikki, Lenguerrand, Erik, Beswick, Andrew D., Gooberman‐Hill, Rachael, Pyke, Mark, Dieppe, Paul, Blom, Ashley W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053254/
https://www.ncbi.nlm.nih.gov/pubmed/26212349
http://dx.doi.org/10.1002/acr.22656
_version_ 1782458378632560640
author Sayers, Adrian
Wylde, Vikki
Lenguerrand, Erik
Beswick, Andrew D.
Gooberman‐Hill, Rachael
Pyke, Mark
Dieppe, Paul
Blom, Ashley W.
author_facet Sayers, Adrian
Wylde, Vikki
Lenguerrand, Erik
Beswick, Andrew D.
Gooberman‐Hill, Rachael
Pyke, Mark
Dieppe, Paul
Blom, Ashley W.
author_sort Sayers, Adrian
collection PubMed
description OBJECTIVE: There is limited information about the extent to which the association between preoperative and chronic postoperative pain is mediated via pain‐on‐movement or pain‐at‐rest. We explored these associations in patients undergoing total hip replacement (THR) and total knee replacement (TKR). METHODS: A total of 322 and 316 patients receiving THR and TKR, respectively, were recruited into a single‐center UK cohort (Arthroplasty Pain Experience) study. Preoperative, acute postoperative, and 12‐month pain severity was measured using self‐reported pain instruments. The association between preoperative/acute pain and chronic postoperative pain was investigated using structural equation modeling (SEM). RESULTS: Patients with high levels of preoperative pain were more likely to report chronic pain after THR (β = 0.195, P = 0.02) and TKR (β = 0.749, P < 0.0001). Acute postoperative pain‐on‐movement was not associated with chronic pain after TKR or THR after adjusting for preoperative pain; however, acute pain‐at‐rest was associated with chronic pain after THR (β = 0.20, P < 0.0002) but not TKR after adjusting for preoperative pain. Analysis of pain‐at‐rest and pain‐on‐movement highlighted differences between THR and TKR patients. Chronic pain‐at‐rest after THR was weakly associated with pain‐at‐rest during the preoperative (β = 0.11, P = 0.068) and acute postoperative period (β = 0.21, P < 0.0001). In contrast, chronic pain‐on‐movement after TKR was strongly associated with the severity of pain‐on‐movement during the preoperative period (β = 0.51, P = 0.001). CONCLUSION: SEM illustrated the different patterns of association between measures of pain over time in patients undergoing THR and TKR for osteoarthritis. These findings highlight the importance of future work that explores the mechanisms underlying pain‐on‐movement and pain‐at‐rest.
format Online
Article
Text
id pubmed-5053254
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-50532542016-10-19 Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements Sayers, Adrian Wylde, Vikki Lenguerrand, Erik Beswick, Andrew D. Gooberman‐Hill, Rachael Pyke, Mark Dieppe, Paul Blom, Ashley W. Arthritis Care Res (Hoboken) Osteoarthritis OBJECTIVE: There is limited information about the extent to which the association between preoperative and chronic postoperative pain is mediated via pain‐on‐movement or pain‐at‐rest. We explored these associations in patients undergoing total hip replacement (THR) and total knee replacement (TKR). METHODS: A total of 322 and 316 patients receiving THR and TKR, respectively, were recruited into a single‐center UK cohort (Arthroplasty Pain Experience) study. Preoperative, acute postoperative, and 12‐month pain severity was measured using self‐reported pain instruments. The association between preoperative/acute pain and chronic postoperative pain was investigated using structural equation modeling (SEM). RESULTS: Patients with high levels of preoperative pain were more likely to report chronic pain after THR (β = 0.195, P = 0.02) and TKR (β = 0.749, P < 0.0001). Acute postoperative pain‐on‐movement was not associated with chronic pain after TKR or THR after adjusting for preoperative pain; however, acute pain‐at‐rest was associated with chronic pain after THR (β = 0.20, P < 0.0002) but not TKR after adjusting for preoperative pain. Analysis of pain‐at‐rest and pain‐on‐movement highlighted differences between THR and TKR patients. Chronic pain‐at‐rest after THR was weakly associated with pain‐at‐rest during the preoperative (β = 0.11, P = 0.068) and acute postoperative period (β = 0.21, P < 0.0001). In contrast, chronic pain‐on‐movement after TKR was strongly associated with the severity of pain‐on‐movement during the preoperative period (β = 0.51, P = 0.001). CONCLUSION: SEM illustrated the different patterns of association between measures of pain over time in patients undergoing THR and TKR for osteoarthritis. These findings highlight the importance of future work that explores the mechanisms underlying pain‐on‐movement and pain‐at‐rest. John Wiley and Sons Inc. 2016-02 2016-01-25 /pmc/articles/PMC5053254/ /pubmed/26212349 http://dx.doi.org/10.1002/acr.22656 Text en © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Osteoarthritis
Sayers, Adrian
Wylde, Vikki
Lenguerrand, Erik
Beswick, Andrew D.
Gooberman‐Hill, Rachael
Pyke, Mark
Dieppe, Paul
Blom, Ashley W.
Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
title Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
title_full Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
title_fullStr Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
title_full_unstemmed Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
title_short Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
title_sort rest pain and movement‐evoked pain as unique constructs in hip and knee replacements
topic Osteoarthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053254/
https://www.ncbi.nlm.nih.gov/pubmed/26212349
http://dx.doi.org/10.1002/acr.22656
work_keys_str_mv AT sayersadrian restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT wyldevikki restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT lenguerranderik restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT beswickandrewd restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT goobermanhillrachael restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT pykemark restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT dieppepaul restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements
AT blomashleyw restpainandmovementevokedpainasuniqueconstructsinhipandkneereplacements