Factors associated with persistent postsurgical pain after total knee or hip joint replacement: A systematic review and meta-analysis

Arunangshu Ghoshal, Shivam Bhanvadia, Som Singh, Lauren Yaeger, Simon Haroutounian

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

Studies have identified demographic, clinical, psychosocial, and perioperative variables associated with persistent pain after a variety of surgeries. This study aimed to perform a systematic review and meta-analysis of factors associated with persistent pain after total knee replacement (TKR) and total hip replacement (THR) surgeries. To meet the inclusion criteria, studies were required to assess variables before or at the time of surgery, include a persistent postsurgical pain (PPSP) outcome measure at least 2 months after a TKR or THR surgery, and include a statistical analysis of the effect of the risk factor(s) on the outcome measure. Outcomes from studies implementing univariate and multivariable statistical models were analyzed separately. Where possible, data from univariate analyses on the same factors were combined in a meta-analysis. Eighty-one studies involving 171,354 patients were included in the review. Because of the heterogeneity of assessment methods, only 44% of the studies allowed meaningful meta-analysis. In meta-analyses, state anxiety (but not trait anxiety) scores and higher depression scores on the Beck Depression Inventory were associated with an increased risk of PPSP after TKR. In the qualitative summary of multivariable analyses, higher preoperative pain scores were associated with PPSP after TKR or THR. This review systematically assessed factors associated with an increased risk of PPSP after TKR and THR and highlights current knowledge gaps that can be addressed by future research.

Original languageEnglish
Pages (from-to)E1052
JournalPain Reports
Volume8
Issue number1
DOIs
StatePublished - Jan 10 2023

Keywords

  • Chronic postsurgical pain
  • Hip replacement
  • Knee replacement
  • Meta-analysis
  • Persistent postsurgical pain
  • Systematic review

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