Hip Pelvis.  2018 Dec;30(4):226-232. 10.5371/hp.2018.30.4.226.

Risk Factors of Neuropathic Pain after Total Hip Arthroplasty

Affiliations
  • 1Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan. epc9719@yahoo.co.jp

Abstract

PURPOSE
Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire.
MATERIALS AND METHODS
One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA.
RESULTS
The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA.
CONCLUSION
THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

Keyword

Hip replacement arthroplasty; Neuropathic pain; Postoperative pain; Pain; Pain measurement

MeSH Terms

Arthroplasty, Replacement, Hip*
Asian Continental Ancestry Group
Hip
Humans
Neuralgia*
Nociceptive Pain
Osteoarthritis
Osteoarthritis, Hip
Pain Measurement
Pain, Postoperative
Risk Factors*

Figure

  • Fig. 1 Patient selection flowchart. THA: total hip arthroplasty.

  • Fig. 2 Pain scores of study participants. The error bars indicate standard deviations. NRS: numerical rating scale.

  • Fig. 3 The relationship between the PainDETECT scores before or 2 months postoperatively and the factors preoperatively. KL: Kellgren-Lawrence, NRS: numerical rating scale, JOA: Japanese Orthopaedic Association, ROM: range of motion, ADL: activities of daily living.

  • Fig. 4 Patient factors before total hip arthroplasty (THA) in the neuropathic and nociceptive pain groups at 2 months after THA. NP: neuropathic pain.

  • Fig. 5 The patient factors before total hip arthroplasty (THA) in the nociceptive and neuropathic pain group at 2 months after THA. KL: Kellgren-Lawrence, NRS: numerical rating scale, JOA: Japanese Orthopaedic Association, ROM: range of motion, ADL: activities of daily living.


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