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Factors Related to Postoperative Pain Trajectories Following Total Knee Arthroplasty: A Longitudinal Study of Patients Admitted to a Russian Orthopaedic Clinic


Affiliations
1 Department of Knee Surgery N 17, Russian Research Institute of Traumatology and Orthopaedics n.a. R.R. Vreden, Saint Petersburg 195427, Russian Federation
2 Department of Surgery, Lovisenberg Diakonale Hospital, 0440 Oslo, Norway
3 Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, United States
4 Department of Knee Surgery N 10, Russian Research Institute of Traumatology and Orthopaedics n.a. R.R. Vreden, Saint Petersburg 195427, Russian Federation
5 Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
6 Department of Nursing Science, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
 

This study explores sociodemographic, clinical, and surgical factors in relation to pain trajectories during the first 3 days following total knee arthroplasty (TKA). 100 patients (mean age 63.5 ± 7.8 years and 93% female) consecutively admitted for uncomplicated primary TKA were prospectively included. Postoperative pain was assessed using pain diaries. Measures of preoperative pain, symptoms, daily functioning, quality of life, comorbidities, knee function, perioperative characteristics, and physical/biochemical parameters were also evaluated. All pain ratings decreased in the three days following surgery (p < .001) as well as the reported number of daily hours in moderate/severe pain (p < .001).Women reported more pain than men (p = .009). Pain trajectories did not differ by education, employment, cohabitation, or any patient clinical and biochemical characteristics but were significantly related to preoperative anxiety (p = .029). Patients reporting moderate/severe pain prior to surgery also reported more hours in moderate/severe pain on days 0-3 postoperatively (p = .029). Patients with surgeries longer than 90 min reported more hours of moderate/severe pain compared with patients who had shorter surgeries (p = .008), and similar results were observed for ratings of pain with activity (p = .012). In this sample, only female gender, higher levels of preoperative pain and anxiety, and longer surgical duration were associated with increased pain after TKA.
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  • Factors Related to Postoperative Pain Trajectories Following Total Knee Arthroplasty: A Longitudinal Study of Patients Admitted to a Russian Orthopaedic Clinic

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Authors

Nikolai Kornilov
Department of Knee Surgery N 17, Russian Research Institute of Traumatology and Orthopaedics n.a. R.R. Vreden, Saint Petersburg 195427, Russian Federation
Maren Falch Lindberg
Department of Surgery, Lovisenberg Diakonale Hospital, 0440 Oslo, Norway
Caryl Gay
Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, United States
Alexander Saraev
Department of Knee Surgery N 17, Russian Research Institute of Traumatology and Orthopaedics n.a. R.R. Vreden, Saint Petersburg 195427, Russian Federation
Taras Kuliaba
Department of Knee Surgery N 10, Russian Research Institute of Traumatology and Orthopaedics n.a. R.R. Vreden, Saint Petersburg 195427, Russian Federation
Leiv Arne Rosseland
Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
Konstantin Muniz
Department of Knee Surgery N 17, Russian Research Institute of Traumatology and Orthopaedics n.a. R.R. Vreden, Saint Petersburg 195427, Russian Federation
Anners Lerdal
Department of Nursing Science, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway

Abstract


This study explores sociodemographic, clinical, and surgical factors in relation to pain trajectories during the first 3 days following total knee arthroplasty (TKA). 100 patients (mean age 63.5 ± 7.8 years and 93% female) consecutively admitted for uncomplicated primary TKA were prospectively included. Postoperative pain was assessed using pain diaries. Measures of preoperative pain, symptoms, daily functioning, quality of life, comorbidities, knee function, perioperative characteristics, and physical/biochemical parameters were also evaluated. All pain ratings decreased in the three days following surgery (p < .001) as well as the reported number of daily hours in moderate/severe pain (p < .001).Women reported more pain than men (p = .009). Pain trajectories did not differ by education, employment, cohabitation, or any patient clinical and biochemical characteristics but were significantly related to preoperative anxiety (p = .029). Patients reporting moderate/severe pain prior to surgery also reported more hours in moderate/severe pain on days 0-3 postoperatively (p = .029). Patients with surgeries longer than 90 min reported more hours of moderate/severe pain compared with patients who had shorter surgeries (p = .008), and similar results were observed for ratings of pain with activity (p = .012). In this sample, only female gender, higher levels of preoperative pain and anxiety, and longer surgical duration were associated with increased pain after TKA.