What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients
TLDR
To review published studies in representative populations with total hip or knee replacement for the treatment of osteoarthritis reporting proportions of people by pain intensity, there is an urgent need to improve general awareness of this possibility and to address determinants of good and bad outcomes.Abstract:
Background Total hip or knee replacement is highly successful when judged by prosthesis-related outcomes. However, some people experience long-term pain. Objectives To review published studies in representative populations with total hip or knee replacement for the treatment of osteoarthritis reporting proportions of people by pain intensity. Data sources MEDLINE and EMBASE databases searched to January 2011 with no language restrictions. Citations of key articles in ISI Web of Science and reference lists were checked. Study eligibility criteria, participants and interventions Prospective studies of consecutive, unselected osteoarthritis patients representative of the primary total hip or knee replacement population, with intensities of patient-centred pain measured after 3 months to 5-year follow-up. Study appraisal and synthesis methods Two authors screened titles and abstracts. Data extracted by one author were checked independently against original articles by a second. For each study, the authors summarised the proportions of people with different severities of pain in the operated joint. Results Searches identified 1308 articles of which 115 reported patient-centred pain outcomes. Fourteen articles describing 17 cohorts (6 with hip and 11 with knee replacement) presented appropriate data on pain intensity. The proportion of people with an unfavourable long-term pain outcome in studies ranged from about 7% to 23% after hip and 10% to 34% after knee replacement. In the best quality studies, an unfavourable pain outcome was reported in 9% or more of patients after hip and about 20% of patients after knee replacement. Limitations Other studies reported mean values of pain outcomes. These and routine clinical studies are potential sources of relevant data. Conclusions and implications of key findings After hip and knee replacement, a significant proportion of people have painful joints. There is an urgent need to improve general awareness of this possibility and to address determinants of good and bad outcomes.read more
Citations
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Journal ArticleDOI
How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up.
Jonathan Evans,Jonathan P Evans,Robert W Walker,Ashley W Blom,Ashley W Blom,Michael R Whitehouse,Michael R Whitehouse,Adrian Sayers +7 more
TL;DR: Patients and surgeons can expect a hip replacement to last 25 years in around 58% of patients, assuming that estimates from national registries are less likely to be biased.
Journal ArticleDOI
Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review.
TL;DR: In this paper, a review of hip and knee OA is presented, focusing on the most common reason for activity limitation in adults. But, the authors do not discuss the treatment of OA in the context of total joint replacement.
Journal ArticleDOI
Assessment and manifestation of central sensitisation across different chronic pain conditions.
Lars Arendt-Nielsen,Bart Morlion,Serge Perrot,Albert Dahan,Anthony H. Dickenson,Hans G. Kress,Chris Wells,Didier Bouhassira,A. Mohr Drewes +8 more
TL;DR: Some common fundamental central pain mechanisms are introduced and how they may translate into the clinical signs and symptoms across different chronic pain conditions, how to evaluate gain and loss of function using quantitative pain assessment tools, and the implications for optimising prevention and management of pain are discussed.
Journal ArticleDOI
Transition from acute to chronic pain after surgery.
TL;DR: This Series provides an overview of the epidemiology and societal effect, basic science, and current recommendations for managing persistent postsurgical pain to promote safer analgesic regimens to better manage patients with acute and chronic pain.
Journal ArticleDOI
The role of microbial biofilms in prosthetic joint infections
TL;DR: The pertinent issues surrounding PJI and the challenges posed by biofilms regarding diagnosis and treatment are discussed and novel strategies of prevention and treatment of biofilm-related PJI are discussed.
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Cochrane Handbook for Systematic Reviews of Interventions
Julian P T Higgins,Sally Green +1 more
TL;DR: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
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Cochrane Handbook for Systematic Reviews of Interventions
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Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.
TL;DR: These large projected increases in demand for total hip and knee arthroplasties provide a quantitative basis for future policy decisions related to the numbers of orthopaedic surgeons needed to perform these procedures and the deployment of appropriate resources to serve this need.