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Assessment of chronic postsurgical pain after knee replacement : a systematic review

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Wylde, Vikki, Bruce, J. (Julie), Beswick, Andrew, Elvers, Karen and Gooberman-Hill, Rachael (2013) Assessment of chronic postsurgical pain after knee replacement : a systematic review. Arthritis Care & Research, Volume 65 (Number 11). pp. 1795-1803. doi:10.1002/acr.22050

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Official URL: http://dx.doi.org/10.1002/acr.22050

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Abstract

Objective: Approximately 20% of patients experience chronic pain after total knee replacement (TKR), yet there is no consensus about how best to assess such pain. This systematic review aimed to identify measures used to characterise chronic pain after TKR.

Methods: MEDLINE, Embase, PsycINFO, Cochrane Library and CINAHL databases were searched for research articles published in all languages from January 2002- November 2011. Articles were eligible for inclusion if they assessed knee pain at a minimum of 3-months after TKR, yielding a total of 1,164 articles. Data extracted included study design, country, timings of assessments, and outcome measures containing pain items. Outcome measures were compared with domains recommended by IMMPACT for inclusion in assessment of chronic pain related outcomes within clinical trials. Temporal trends were also explored.

Results: The review found use of a wide variety of composite and single-item measures, with the American Knee Society Score most common. Many measures used in published studies do not capture the multi-dimensional nature of pain recommended by IMMPACT; of those commonly used, the WOMAC and Oxford Knee Score are most comprehensive. Geographical trends were evident, with nation-specific preferences for particular measures. A recent reduction in use of some clinically-administered tools was accompanied by increased use of patient-reported outcome measures.

Conclusion: There was wide variation in methods of pain assessment alongside nation-specific preferences and changing temporal trends in pain assessment after TKR. Standardisation and improvements in assessment is needed to enhance the quality of research and facilitate the establishment of a core outcome set.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Total knee replacement, Chronic pain , Evidence-based medicine, Systematic reviews (Medical research)
Journal or Publication Title: Arthritis Care & Research
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 2151-464X
Official Date: November 2013
Dates:
DateEvent
November 2013Published
Volume: Volume 65
Number: Number 11
Page Range: pp. 1795-1803
DOI: 10.1002/acr.22050
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: National Institute for Health Research (Great Britain) (NIHR)
Grant number: RP-PG-0407-10070

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