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Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis

BACKGROUND: In patients with hip osteoarthritis (OA), pain at rest, unlike pain on activity, is due to pain mechanisms that cannot be explained by nociceptive pain. However, it remains unclear whether central sensitization (CS) is one of the causes of exacerbated pain at rest in patients with hip OA...

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Autores principales: Ohashi, Yoshihisa, Fukushima, Kensuke, Uchida, Kentaro, Koyama, Tomohisa, Tsuchiya, Maho, Saito, Hiroki, Uchiyama, Katsufumi, Takahira, Naonobu, Inoue, Gen, Takaso, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542571/
https://www.ncbi.nlm.nih.gov/pubmed/34707402
http://dx.doi.org/10.2147/JPR.S322314
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author Ohashi, Yoshihisa
Fukushima, Kensuke
Uchida, Kentaro
Koyama, Tomohisa
Tsuchiya, Maho
Saito, Hiroki
Uchiyama, Katsufumi
Takahira, Naonobu
Inoue, Gen
Takaso, Masashi
author_facet Ohashi, Yoshihisa
Fukushima, Kensuke
Uchida, Kentaro
Koyama, Tomohisa
Tsuchiya, Maho
Saito, Hiroki
Uchiyama, Katsufumi
Takahira, Naonobu
Inoue, Gen
Takaso, Masashi
author_sort Ohashi, Yoshihisa
collection PubMed
description BACKGROUND: In patients with hip osteoarthritis (OA), pain at rest, unlike pain on activity, is due to pain mechanisms that cannot be explained by nociceptive pain. However, it remains unclear whether central sensitization (CS) is one of the causes of exacerbated pain at rest in patients with hip OA. Therefore, we investigated the differences in causative factors and postoperative course of total hip arthroplasty (THA) between preoperative pain at rest and on activity in patients with hip OA. METHODS: In total, 120 patients (125 hips, 22 men and 98 women, aged 64.5±1.0 years) with hip OA were included. Preoperative pain at rest and on activity and CS were assessed using the visual analog scale (VAS) and CS Inventory (CSI), respectively. Postoperative assessments were evaluated using the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ); pain, satisfaction, function, and mental scores were evaluated 6 and 12 months after THA. RESULTS: Multivariate regression analysis indicated the CSI score as affecting VAS for pain at rest (β=0.067, P=0.002) but not VAS for pain on activity (β=0.036, P=0.073). VAS for pain at rest had a weak negative correlation with satisfaction and pain scores at both 6 and 12 months after THA (satisfaction, r=−0.309, −0.278; pain, r=−0.202, −0.22). VAS for pain on activity was not correlated with JHEQ. The CSI score had a weak or moderate negative correlation with three scores other than the function score at both 6 and 12 months after THA (satisfaction, r=−0.266, −0.213; pain, r=−0.332, −0.203, mental, r=−0.427, −0.370). The function score was weakly correlated with the CSI score only 6 months after THA (function, r=−0.231, −0.190). CONCLUSION: A higher level of preoperative pain at rest, a CS-related symptom, may affect postoperative pain persistence and dissatisfaction in patients with hip OA.
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spelling pubmed-85425712021-10-26 Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis Ohashi, Yoshihisa Fukushima, Kensuke Uchida, Kentaro Koyama, Tomohisa Tsuchiya, Maho Saito, Hiroki Uchiyama, Katsufumi Takahira, Naonobu Inoue, Gen Takaso, Masashi J Pain Res Original Research BACKGROUND: In patients with hip osteoarthritis (OA), pain at rest, unlike pain on activity, is due to pain mechanisms that cannot be explained by nociceptive pain. However, it remains unclear whether central sensitization (CS) is one of the causes of exacerbated pain at rest in patients with hip OA. Therefore, we investigated the differences in causative factors and postoperative course of total hip arthroplasty (THA) between preoperative pain at rest and on activity in patients with hip OA. METHODS: In total, 120 patients (125 hips, 22 men and 98 women, aged 64.5±1.0 years) with hip OA were included. Preoperative pain at rest and on activity and CS were assessed using the visual analog scale (VAS) and CS Inventory (CSI), respectively. Postoperative assessments were evaluated using the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ); pain, satisfaction, function, and mental scores were evaluated 6 and 12 months after THA. RESULTS: Multivariate regression analysis indicated the CSI score as affecting VAS for pain at rest (β=0.067, P=0.002) but not VAS for pain on activity (β=0.036, P=0.073). VAS for pain at rest had a weak negative correlation with satisfaction and pain scores at both 6 and 12 months after THA (satisfaction, r=−0.309, −0.278; pain, r=−0.202, −0.22). VAS for pain on activity was not correlated with JHEQ. The CSI score had a weak or moderate negative correlation with three scores other than the function score at both 6 and 12 months after THA (satisfaction, r=−0.266, −0.213; pain, r=−0.332, −0.203, mental, r=−0.427, −0.370). The function score was weakly correlated with the CSI score only 6 months after THA (function, r=−0.231, −0.190). CONCLUSION: A higher level of preoperative pain at rest, a CS-related symptom, may affect postoperative pain persistence and dissatisfaction in patients with hip OA. Dove 2021-10-20 /pmc/articles/PMC8542571/ /pubmed/34707402 http://dx.doi.org/10.2147/JPR.S322314 Text en © 2021 Ohashi et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Ohashi, Yoshihisa
Fukushima, Kensuke
Uchida, Kentaro
Koyama, Tomohisa
Tsuchiya, Maho
Saito, Hiroki
Uchiyama, Katsufumi
Takahira, Naonobu
Inoue, Gen
Takaso, Masashi
Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis
title Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis
title_full Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis
title_fullStr Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis
title_full_unstemmed Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis
title_short Adverse Effects of Higher Preoperative Pain at Rest, a Central Sensitization-Related Symptom, on Outcomes After Total Hip Arthroplasty in Patients with Osteoarthritis
title_sort adverse effects of higher preoperative pain at rest, a central sensitization-related symptom, on outcomes after total hip arthroplasty in patients with osteoarthritis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542571/
https://www.ncbi.nlm.nih.gov/pubmed/34707402
http://dx.doi.org/10.2147/JPR.S322314
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