Total knee replacement (TKA) is the best option for painrelief in your knee. However, the majority of studies that discuss the success ofTKA don't take into account the factors that will determine the level offreedom from pain over the years following the procedure.
This topic was highlighted in a 2008 study. Theresearchers found that between 13% and 30% of patients who underwent a TKA hada slow, painful, or incomplete recovery. They also discovered two key factorsthat could help predict which people with osteoarthritis (OA), who will likelystill experience pain two years after their surgery. These factors includedother medical conditions and the way people experience pain.
The study tracked 55 consecutive OA patients who werescheduled for a TKA at a Nova Scotia hospital. A total of 35 patients(including 20 women) were averaging 69. They completed pain questionnairesprior to surgery and again three months later, 12 months later, and two yearslater. The standard survey was used toevaluate the pain of the women and men in the study. Additionally, theresearchers used medical records to determine other health conditions. These problems included OA in other joints, high bloodpressure and smoking. They also found out about their other health issues suchas diabetes, heart disease, depression, heart disease, heart disease, heartdisease, heart disease, heart disease, and obesity. Researchers also examined a psychological characteristiccalled "catastrophizing" that reflects how women and men experiencepain. The Pain Catastrophizing Scale is awidely-used survey that asks men and women to rate the frequency with which 13statements regarding pain apply to them. Thesestatements measure how often they reflect on their pain, how severe it is andhow helpless they feel in managing it.
Scientists found that men and women were equally likelyto suffer from catastrophizing. However, the pain levels of both men and womendecreased significantly after knee replacement surgery. There was also a largevariation in their experiences. The study's goal was to determine which factors wereresponsible for the variance, and how they can be used to predict who willsuffer from the pain.
The factors that predicted pain after two years were notage, gender, length of stay in hospital, and type of anesthesia used by thewomen and men weren't predictive of it. Not surprisingly, patients with theworst presurgery pain were more likely than those who had the least pain twoyears later. This raisesquestions about the practice of waiting until the pain becomes unbearablebefore undergoing TKA.
It was significant to predict who would experience painin two years' time for both men and women whose catastrophizing scores,particularly the reflection about pain, were high. Two years later, thenumber of medical conditions that the participants had at the time theyunderwent surgery was another predictor of future pain. Scientists tried to explain why catastrophizing can lead tocontinuing pain experience. They suggested that focusing on pain and reflectingon it may increase the cells' ability to feel pain. People with medical problems might also pay more attentionto pain than those with OA in their knees. Its limitations include its small size, and the inability toexamine whether long-term pain after TKA surgery.
Researchers hope that their research will identify peopleat high risk of persistent pain after knee replacement. This could allow for theuse of psychological intervention or aggressive pain management to reducelong-term disability and distress in patients who have had total kneereplacements.
