N/A
N=179
Persistent Postoperative Pain and Joint Stiffness After Total Knee Arthroplasty Performed for Osteoarthritis
Pain · Joint Stiffness
Bottom Line
View on ClinicalTrials.gov: NCT02626533 ↗Enrolled (actual)
179
Serious AEs
0.0%
Results posted
Jul 2024
Primary outcome: Primary: Presence of Persistent Postoperative Pain Using the Numeric Rating Scale (NRS) — 10 Participants
Study Design & Population
- Study type
- Observational
- Phase
- N/A
- Interventions
- Total Knee Arthroplasty (Procedure)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Hospital for Special Surgery, New York
- Primary completion
- Aug 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Presence of Persistent Postoperative Pain Using the Numeric Rating Scale (NRS) |
10 | — |
| SECONDARY Patients Who Experienced Postoperative Joint Stiffness |
32 | — |
| SECONDARY Postoperative Knee Range of Motion |
84; 115.3 | — |
| SECONDARY NRS Pain at Rest on POD1 |
4.9; 3.2 | — |
| SECONDARY NRS Pain With Movement on POD1 |
7.6; 4.9 | — |
| SECONDARY Worst NRS Pain on POD1 |
7.7; 6 | — |
| SECONDARY Least NRS Pain on POD1 |
1.5; 1.2 | — |
| SECONDARY NRS Pain at Rest on POD2 |
5.3; 3.2 | — |
| SECONDARY NRS Pain With Movement on POD2 |
7.4; 6.2 | — |
| SECONDARY Worst NRS Pain on POD2 |
9.1; 7.7 | — |
| SECONDARY Least NRS Pain on POD2 |
3.1; 1.8 | — |
| SECONDARY NRS Pain at Rest 4 Weeks After Surgery |
2.9; 2 | — |
| SECONDARY NRS Pain With Movement 4 Weeks After Surgery |
4.3; 3.3 | — |
| SECONDARY Worst NRS Pain 4 Weeks After Surgery |
5.9; 5.4 | — |
| SECONDARY Least NRS Pain 4 Weeks After Surgery |
1.5; 0.8 | — |
| SECONDARY NRS Pain at Rest 3 Months After Surgery |
2.4; 0.8 | — |
| SECONDARY NRS Pain With Movement 3 Months After Surgery |
3.4; 1.5 | — |
| SECONDARY Worst NRS Pain 3 Months After Surgery |
4.1; 2.3 | — |
| SECONDARY Least NRS Pain 3 Months After Surgery |
0.8; 0.3 | — |
| SECONDARY NRS Pain at Rest 6 Months After Surgery |
2.4; 0.4 | — |
| SECONDARY Least NRS Pain 6 Months After Surgery |
0.7; 0.1 | — |
| SECONDARY Worst NRS Pain 6 Months After Surgery |
6.5; 1.4 | — |
| SECONDARY Postoperative Knee Injury and Osteoarthritis Outcome (KOOS) Scores |
37; 32; 18; 20; 32; 33 | — |
| SECONDARY Postoperative painDETECT Scores |
6.7; 7; 6.2; 3.5; 4.9; 1.4 | — |
| SECONDARY Types of Preoperative Medications |
73; 0; 4; 20; 1; 4 | — |
Summary
Persistent pain and joint stiffness after surgery may interfere with recovery and adversely affect quality of life in up to 40% of patients who have undergone total knee arthroplasty. There is growing evidence that inflammation as well as other medical and psychological factors may be associated with osteoarthritis severity, progression, and associated pain severity. This study aims to identify clinical, biological, and psychological factors that contribute to and predict the development of these complications. Identification of such factors may allow us to target preventative measures to the patients at highest risk of persistent postoperative pain and joint stiffness.
Eligibility Criteria
Inclusion Criteria
- Elective primary unilateral total knee arthroplasty
- Osteoarthritis with radiologic evidence of "severe narrowing" and/or "bone on bone" in the affected joint
- Patients of surgeons who have agreed to participate in the study
- Age > 18 years
- American Society of Anesthesiologists (ASA) Physical Status 1-3
- Regional anesthesia
- Epidural patient-controlled analgesia (PCA) for postoperative pain
- Adductor canal block for postoperative pain
Exclusion Criteria
- Contraindication to regional anesthesia, NSAIDs, dexamethasone or acetaminophen
- Use of general anesthesia
- History of >6 weeks of daily opioid use and/or any use of non-prescribed opioids
- Preoperative oral steroid use in the past 6 months
- Intra-articular steroid injection within one month of scheduled surgery in affected joint
- Non-English speakers
- Pre-existing diagnosis of rheumatic disease or autoimmune disease (e.g. rheumatoid arthritis, psoriatic arthritis, inflammatory bowel disease, multiple sclerosis, Type I diabetes)
- Peri-articular injections or infusions for postoperative pain
- Diagnosis of crystalline arthropathy
- Diagnosis of osteonecrosis
- Active infection or use of antibiotics
- Pregnant women
Data sourced from ClinicalTrials.gov (NCT02626533). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.