Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Colovic, D; Draschl, A; Reinbacher, P; Hecker, A; Schittek, G; Fischerauer, SF; Leithner, A; Klim, SM; Koutp, A; Wittig, U; Brunnader, K; Sandner-Kiesling, A; Sadoghi, P.
Evaluation of Neuropathic Pain after Total Knee Arthroplasty: Do Yellow Flags Matter?
J Clin Med. 2023; 12(24):
Doi: 10.3390/jcm12247708
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- Co-Autor*innen der Med Uni Graz
- Brunnader Kevin
- Fischerauer Stefan Franz
- Hecker Andrzej Stanislaw
- Klim Sebastian Martin
- Koutp Amir
- Leithner Andreas
- Reinbacher Patrick
- Sadoghi Patrick
- Sandner-Kiesling Andreas
- Schittek Gregor Alexander
- Wittig Ulrike
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- Abstract:
- UNLABELLED: Up to 20% of total knee arthroplasty (TKA) patients continue to experience chronic postsurgical pain. Various factors have been identified as potential contributors, including so-called "yellow flags", encompassing symptoms of depression, anxiety, and catastrophizing, which were examined in this study to assess their predictive value concerning functional outcomes after TKA. METHODS: Fifty TKA patients were categorized into high-risk and low-risk groups based on clinical assessment, demographic data, medication, and patient-reported outcome measures (DN4, SF-36, WOMAC, NRS, Fibromyalgia Survey Questionnaire, Pain Catastrophizing Scale, and Hospital Anxiety and Depression Scale). Postoperative outcomes within six months after TKA were then compared. RESULTS: Both groups exhibited significant (p < 0.001) improvements in all WOMAC and NRS subscales, as well as in the physical function, role physical, pain, and energy/fatigue subdomains of the SF-36 after six months, while the high-risk group showed lower WOMAC scores regarding stiffness (19.0 ± 18.3 vs. 27.2 ± 20.7, p < 0.001) and pain (13.5 ± 13.3 vs. 15.1 ± 16.3, p = 0.029). The high-risk group showed significantly worse preoperative DN4 scores (1.8 ± 1.3 vs. 3.0 ± 1.1, p = 0.002) than the low-risk group, which persisted for one day (2.3 ± 1.2 vs. 3.5 ± 1.5, p = 0.005) and six weeks (2.2 ± 1.9 vs. 3.6 ± 2.3, p = 0.041) postoperatively. CONCLUSIONS: Our results indicate that pre-existing yellow flags contribute to a more challenging early postoperative phase, underscoring the importance of considering individual patient characteristics and psychological factors to optimize TKA outcomes.
- Find related publications in this database (Keywords)
- chronic postoperative pain
- neuropathic pain
- total knee arthroplasty
- yellow flags