Chronic pain is an extremely disabling disease. It is a major public health problem due to the lack of effective therapy. Chronic postoperative pain (CPOP) is defined by a painful symptomatology in the operated area unrelated to previous pain, present for more than 3 months, and without any link to surgical complication. The prevalence of chronicization of postoperative pain is 30% after total knee arthroplasty. Identification of clinical, biological and psychological profiles are crucial to prevent CPOP. A biologic factor, Brain Derived Neurotrophic Factor (BDNF) produced by a variety of cells is a key regulator of neuroplasticity. BDNF is increasingly studied in the mechanisms of cerebral sensitization and pain chronicization. The role of BDNF in pain of patients remains to be explored in a prospective study. The aim of this observational study is to compare the kinetics of BDNF after total knee arthroplasty in patients with and without CPOP. Patients will be included in the study at the preanesthetic consultation. Serum BDNF levels will be measured preoperatively, 48h postoperatively, 3 and 6 months after surgery.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
200
blood test to explore BDNF level
Department of Anesthesiology and critical care, Lapeyronie University Hospital
Montpellier, France
BDNF level
assessed by ELISA technique
Time frame: preoperative to 6 months after surgery
Pain level
evaluated by Visual Analog Scale (VAS)
Time frame: preoperative to 6 months after surgery
Neuropathic pain diagnostic
evaluated by neuropathic pain diagnostic questionnaire (DN4)
Time frame: preoperative to 6 months after surgery
Postoperative rehabilitation
evaluated by the Brief Pain Questionary (BPI)
Time frame: preoperative to 6 months after surgery
Health related quality of life
evaluated by the SF-12 Health Survey
Time frame: preoperative to 6 months after surgery
Anxiety and Depression
evaluated by the Hospital Anxiety and Depression scale (HAD)
Time frame: preoperative to 6 months after surgery
Pain level perception
evaluated by the The pain Catastrophizing Scale
Time frame: preoperative to 6 months after surgery
Assessment of functional capacities in knee arthritis
evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC)
Time frame: preoperative to 6 months after surgery
Oxidative stress marker
8-iso-prostaglandin F2α level by biochemical labeling
Time frame: preoperative to 6 months after surgery
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