Quantitative Sensory Testing Following Orthopedic Trauma: A Longitudinal Multisite Feasibility Study

Area of Science:

• Orthopedic surgery outcomes
• Pain medicine research
• Clinical trial methodology

Background:

• Orthopedic trauma is a leading cause of chronic pain and disability globally.
• Quantitative sensory testing (QST) offers a standardized method to evaluate pain sensitivity post-injury.
• Characterizing pain profiles may aid in predicting and managing chronic pain development.

Purpose of the Study:

• To assess the feasibility and acceptability of a portable Quantitative Sensory Testing (QST) protocol.
• To administer QST to adults six weeks after major orthopedic trauma and surgery.
• To explore the relationship between QST measures and patient-reported pain.

Main Methods:

• A cohort of 29 participants with major orthopedic trauma underwent QST at 6 weeks post-surgery.
• QST included static measures, conditioned pain modulation, and mechanical temporal summation.
• Feasibility, acceptability, and associations with clinical pain ratings were examined, with a 6-month follow-up survey planned.

Main Results:

• Recruitment achieved 77% of eligible patients; QST procedures were feasible and well-tolerated.
• No participants declined, withdrew due to procedures, or stopped testing due to discomfort.
• Exploratory analysis showed a positive association between static QST and pain interference; however, 6-month retention was 57% and analgesic use was high (38%).

Conclusions:

• Quantitative Sensory Testing (QST) demonstrated acceptability and partial feasibility in adults post-orthopedic trauma.
• Key challenges identified include poor participant retention, high analgesic use, and logistical difficulties in testing injured areas.
• Potential solutions are proposed to overcome these barriers in future research on chronic pain prediction.