AIM: To study the prevalence of persistent post-surgical pain(PPSP) and neuropathic pain(NP) after total knee replacement(TKR).METHODS: MEDLINE and Embase databases were searched for articles published until December ...AIM: To study the prevalence of persistent post-surgical pain(PPSP) and neuropathic pain(NP) after total knee replacement(TKR).METHODS: MEDLINE and Embase databases were searched for articles published until December 2014 in English language. Published articles were included if they referred to pain that lasts at least 3 mo after primary TKR for knee osteoarthritis, and measured pain with pain specific instruments. Studies that referred to pain caused by septic reasons and implant malalignment were excluded. Both prospective and retrospective studies were included and only 14 studies that match the inclusion criteria were selected for this review.RESULTS: The included studies were characterized by the heterogeneity on the scales used to measure pain and pre-operative factors related to PPSP and NP. The reported prevalence of PPSP and NP seems to be relatively high, but it varies among different studies. There is also evidence that the prevalence of post-surgical pain is related to the scale used for pain measurement. The prevalence of PPSP is ranging at 6 mo from 16% to 39% and at 12 mo from 13.1% to 23% and even 38% of the patients. The prevalence of NP at 6 mo post-operatively is ranging from 5.2% to13%. Pre-operative factors related to the development of PPSP also differ, including emotional functioning, such as depression and pain catastrophizing, number of comorbidities, pain problems elsewhere and operations in knees with early grade of osteoarthritis.CONCLUSION: No firm conclusions can be reached regarding the prevalence of PPSP and NP and the related factors due to the heterogeneity of the studies.展开更多
目的系统评价全膝关节置换术后慢性疼痛相关危险因素,为更好地预防和管理全膝置换术后疼痛提供循证证据。方法计算机检索中国知网、万方数据库、维普网、PubMed、Embase、Cochrane Library、Web of Science等数据库,收集有关全膝关节置...目的系统评价全膝关节置换术后慢性疼痛相关危险因素,为更好地预防和管理全膝置换术后疼痛提供循证证据。方法计算机检索中国知网、万方数据库、维普网、PubMed、Embase、Cochrane Library、Web of Science等数据库,收集有关全膝关节置换术后慢性疼痛危险因素的队列或病例对照研究,检索时限均为建库起至2023年6月。根据纳排标准,筛选并提取纳入文献的基本信息,予以质量评估并偏倚分析。采用RevMan 5.4软件对数据进行Meta分析。结果最终纳入文献11篇,中文文献4篇,英文文献7篇,包括患者2669例,实验组816例,对照组1853例。Meta分析的结果显示,性别、教育水平、种族、特质焦虑、WOMAC骨性关节炎指数、NRS疼痛评分是全膝关节置换术后慢性疼痛的高危因素(P<0.05)。结论性别、教育水平、种族、特质焦虑指数、术前WOMAC评分、术前NRS评分为全膝关节置换术后慢性疼痛的独立危险因素,临床医师可重点识别并针对性控制高危因素,并对可干预因素予以针对性控制,以预防或减少人工全膝关节置换术后慢性疼痛的发生。展开更多
目的:探讨膝周神经射频热凝联合玻璃酸钠注射治疗顽固性膝骨关节炎疼痛的临床效果。方法:36例严重膝骨关节炎疼痛的患者,共57个患膝,随机分为两组:射频加玻璃酸钠组(R组),行膝周神经射频热凝加关节腔内玻璃酸钠注射;对照组(C组),单纯关...目的:探讨膝周神经射频热凝联合玻璃酸钠注射治疗顽固性膝骨关节炎疼痛的临床效果。方法:36例严重膝骨关节炎疼痛的患者,共57个患膝,随机分为两组:射频加玻璃酸钠组(R组),行膝周神经射频热凝加关节腔内玻璃酸钠注射;对照组(C组),单纯关节腔内玻璃酸钠注射。分别于治疗前、治疗后1周、治疗后6周和治疗后12周,记录患者疼痛视觉模拟评分(visual analoguescale,VAS)、患者对治疗效果综合评估(patient's global assessment,PGA)和不良反应。结果:治疗后的12周内,R组VAS评分显著低于C组。R组PGA在第1周和第12周均显著高于C组。所有患者均未发生明显的不良反应。结论:膝周神经射频热凝联合玻璃酸钠注射治疗顽固性膝骨关节痛效果明显,安全可靠,可成为治疗老年性膝骨关节炎的有效手段。展开更多
文摘AIM: To study the prevalence of persistent post-surgical pain(PPSP) and neuropathic pain(NP) after total knee replacement(TKR).METHODS: MEDLINE and Embase databases were searched for articles published until December 2014 in English language. Published articles were included if they referred to pain that lasts at least 3 mo after primary TKR for knee osteoarthritis, and measured pain with pain specific instruments. Studies that referred to pain caused by septic reasons and implant malalignment were excluded. Both prospective and retrospective studies were included and only 14 studies that match the inclusion criteria were selected for this review.RESULTS: The included studies were characterized by the heterogeneity on the scales used to measure pain and pre-operative factors related to PPSP and NP. The reported prevalence of PPSP and NP seems to be relatively high, but it varies among different studies. There is also evidence that the prevalence of post-surgical pain is related to the scale used for pain measurement. The prevalence of PPSP is ranging at 6 mo from 16% to 39% and at 12 mo from 13.1% to 23% and even 38% of the patients. The prevalence of NP at 6 mo post-operatively is ranging from 5.2% to13%. Pre-operative factors related to the development of PPSP also differ, including emotional functioning, such as depression and pain catastrophizing, number of comorbidities, pain problems elsewhere and operations in knees with early grade of osteoarthritis.CONCLUSION: No firm conclusions can be reached regarding the prevalence of PPSP and NP and the related factors due to the heterogeneity of the studies.
文摘目的系统评价全膝关节置换术后慢性疼痛相关危险因素,为更好地预防和管理全膝置换术后疼痛提供循证证据。方法计算机检索中国知网、万方数据库、维普网、PubMed、Embase、Cochrane Library、Web of Science等数据库,收集有关全膝关节置换术后慢性疼痛危险因素的队列或病例对照研究,检索时限均为建库起至2023年6月。根据纳排标准,筛选并提取纳入文献的基本信息,予以质量评估并偏倚分析。采用RevMan 5.4软件对数据进行Meta分析。结果最终纳入文献11篇,中文文献4篇,英文文献7篇,包括患者2669例,实验组816例,对照组1853例。Meta分析的结果显示,性别、教育水平、种族、特质焦虑、WOMAC骨性关节炎指数、NRS疼痛评分是全膝关节置换术后慢性疼痛的高危因素(P<0.05)。结论性别、教育水平、种族、特质焦虑指数、术前WOMAC评分、术前NRS评分为全膝关节置换术后慢性疼痛的独立危险因素,临床医师可重点识别并针对性控制高危因素,并对可干预因素予以针对性控制,以预防或减少人工全膝关节置换术后慢性疼痛的发生。
文摘目的:探讨膝周神经射频热凝联合玻璃酸钠注射治疗顽固性膝骨关节炎疼痛的临床效果。方法:36例严重膝骨关节炎疼痛的患者,共57个患膝,随机分为两组:射频加玻璃酸钠组(R组),行膝周神经射频热凝加关节腔内玻璃酸钠注射;对照组(C组),单纯关节腔内玻璃酸钠注射。分别于治疗前、治疗后1周、治疗后6周和治疗后12周,记录患者疼痛视觉模拟评分(visual analoguescale,VAS)、患者对治疗效果综合评估(patient's global assessment,PGA)和不良反应。结果:治疗后的12周内,R组VAS评分显著低于C组。R组PGA在第1周和第12周均显著高于C组。所有患者均未发生明显的不良反应。结论:膝周神经射频热凝联合玻璃酸钠注射治疗顽固性膝骨关节痛效果明显,安全可靠,可成为治疗老年性膝骨关节炎的有效手段。
