Diabetes is associated with persistent pain after hip and knee replacement

Area of Science:

• Orthopedic Surgery
• Metabolic Disorders
• Pain Management

Background:

• Persistent pain after joint replacement surgery, particularly knee arthroplasty, affects a significant patient subset.
• The underlying reasons for this post-operative pain remain incompletely understood.

Purpose of the Study:

• To determine the prevalence of persistent pain following primary hip and knee replacement.
• To investigate the association between persistent pain and glucose metabolism disorders, metabolic syndrome (MetS), and obesity.

Main Methods:

• A prospective study surveyed 134 osteoarthritis patients 1-2 years post-primary hip or knee replacement.
• Persistent pain was defined as daily pain lasting over 3 months.
• Binary logistic regression analyzed factors associated with persistent pain, adjusting for age, sex, and operated joint.

Main Results:

• 14% of patients experienced persistent pain 1-2 years after joint replacement.
• Knee replacement patients had higher rates of painful (46%) and persistent pain (20%) compared to hip replacement patients (24% and 4%).
• Previously diagnosed diabetes was a strong risk factor (OR=8) for persistent pain; metabolic syndrome and general obesity were not significant factors, though severe obesity (BMI ≥ 35) was linked to a painful joint.

Conclusions:

• Previously diagnosed diabetes is a significant risk factor for developing persistent pain after primary hip or knee replacement.
• The findings highlight the importance of considering metabolic health in managing post-arthroplasty pain.