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Increased tender point counts before and after total hip arthroplasty are associated with poorer outcomes but are not
Earl R Bogoch1, Eli Olschewski, Philippe Zangger
1Li Ka Shing Knowledge Institute and the Mobility Program Clinical Research Unit, Division of Orthopaedic Surgery, Department of Surgery, Martin Family Centre for Arthritis Care and Research, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract:
In a prospective study, total hip arthroplasty (THA) patients were assessed preoperatively and postoperatively (n = 95) to determine if tender points (TPs) are associated with poor THA outcomes. Patients with high follow-up TP counts had higher visual analog scale (VAS) for pain and sleep, higher follow-up Western Ontario and McMaster Universities Arthritis Index (pain, stiffness, function), lower Health Assessment Questionnaire, Harris Hip, and Short Form 36 (physical functioning, bodily pain, physical component summary) scores. High follow-up TP were associated with increased pain, pain not relieved by surgery, poor function, and poor sleep. Visual analog scale pain and sleep, Short Form 36 (physical functioning, bodily pain), Western Ontario and McMaster Universities Arthritis Index, Health Assessment Questionnaire, and Harris hip scores improved significantly after THA; TP scores did not. Higher preoperative TP were predictive of higher follow-up TP but were poorly predictive of poor outcome measures after surgery in individual patients, suggesting that preoperative TPs are not [corrected] contraindicative for THA.