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Conditioned pain modulation predicts persistent pain after knee replacement surgery
Christian Dürsteler1, Yusmely Salazar2, Uxia Rodriguez3
1Pain Medicine Section, Anaesthesiology Department, Hospital Clínic de Barcelona, Barcelona, Spain.
Pain Reports
|April 5, 2021
Summary
Preoperative sensory testing can identify patients likely to experience persistent pain after total knee replacement. This helps surgeons select appropriate candidates for surgery, improving outcomes and reducing the burden of chronic pain.
Area of Science:
- Pain research
- Orthopedic surgery
- Neuroscience
Background:
- Persistent pain post-total knee replacement (TKR) is a significant issue.
- Quantitative sensory testing (QST) and conditioned pain modulation (CPM) assess endogenous analgesia.
- Poor preoperative pain inhibition predicts persistent postoperative pain.
Purpose of the Study:
- To investigate the link between preoperative endogenous analgesia and poor TKR outcomes.
- To determine if QST can predict persistent pain after TKR.
Main Methods:
- 146 patients underwent preoperative QST.
- Conditioned pain modulation (CPM) measured endogenous analgesia.
- Correlation analysis assessed relationships between preoperative measures and postoperative pain.
Main Results:
- 21.2% of patients reported persistent pain 6 months post-surgery.
- 47.9% had insufficient preoperative endogenous analgesia, with higher pain persistence rates (31.4% vs 11.8%).
- Lower preoperative quality of life (mental component) also predicted worse pain outcomes.
Conclusions:
- Preoperative sensory testing, specifically CPM, is a valuable predictor of persistent pain after TKR.
- This tool can aid clinicians in patient selection for knee replacement surgery.
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