Osteoarthritis (OA) is disease in which the joint breaks down, causing pain. The decision to surgically replace the knee, a procedure called total knee arthroplasty (TKA), depends on x-ray results as well as pain and dysfunction. Despite TKA resulting in good outcomes for most patients, between 1 in 10 and 1 in 5 patients remain in significant pain - i.e., are 'TKA non-responders'. Two pain conditions - myofascial pain syndrome (MPS) and central sensitization - frequently coexist with signs of OA and may contribute to a TKA non-responder profile. MPS, caused by knots within skeletal muscle, can contribute to an OA patient's pain and dysfunction. In central sensitization, faulty pain sensing leads to increased pain sensitivity. However, there is currently no established process to identify these sources of pain and potential associated TKA non-responder risk. Our research aims conduct a pilot study to examine the impact of pain diagnosis tools to help orthopedic surgeons identify potential TKA nonresponders. This new approach may increase healthcare efficiency (reduce TKA waitlist and length of hospital stay), and help patients receive the right care at the right time.
Study Type
OBSERVATIONAL
Enrollment
55
n/a, observational study
St. Joseph's Healthcare Hamilton
Hamilton, Ontario, Canada
NOT_YET_RECRUITINGToronto Western Hospital
Toronto, Ontario, Canada
RECRUITINGClinical prediction model feasibility as determined by: Recruitment rate, follow-up at 12 months post-op, multivariable logistic regression
Time frame: 21 months
Pain regions and pain pattern, as assessed by Pain Body Diagram
Time frame: 21 months
Likelihood of neuropathic pain component, as assessed by the painDETECT questionnaire
Time frame: 21 months
Symptoms of central sensitisation, as assessed by the Central Sensitization Inventory questionnaire
Time frame: 21 months
Physical function, as assessed by the Aggregate Locomotor Function test
Time frame: 21 months
Prevalence of myofascial trigger points
Time frame: 21 months
Pain facilitation, as assessed by Temporal Summation of Pain (wind-up)
Time frame: 21 months
Deep tissue pain sensitivity, as assessed by Pain Pressure Threshold
Time frame: 21 months
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