Tras la colocación de prótesis de cadera y rodilla un significativo número de personas continúan con dolor

http://www.ncbi.nlm.nih.gov/pubmed/22357571

Tras la colocación de prótesis de cadera y rodilla un significativo número de personas continúan con dolor.

BMJ Open, 22/02/2012, “What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients”.

Revisión sistemática de publicaciones incluyendo catorce artículos sobre el dolor tras la colocación de prótesis que describen 17 cohortes (6 con la cadera y 11 con rodilla). La proporción de personas con un resultado desfavorable por dolor a largo plazo osciló entre el 7% a 23% después del reemplazo de la cadera y del 10% a 34% después de reemplazo de rodilla. En los estudios de mejor calidad, presentaban dolor al menos un 9% de los pacientes con prótesis de la cadera y alrededor del 20% de los pacientes después de la sustitución de rodilla. Los autores concluyen que tras el reemplazo de cadera y rodilla, una proporción significativa de pacientes tienen dolor en las articulaciones operadas. Es necesario mejorar el conocimiento del problema para abordar los determinantes de los buenos y malos resultados.

http://www.ncbi.nlm.nih.gov/pubmed/22357571

BMJ Open. 2012 Feb 22;2(1):e000435. doi: 10.1136/bmjopen-2011-000435. Print 2012.

What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients.

Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P.

Source

School of Clinical Sciences, University of Bristol, Bristol, UK.

Abstract

BACKGROUND:

Total hip or knee replacement is highly successful when judged by prosthesis-related outcomes. However, some people experience long-term pain.

OBJECTIVES:

To review published studies in representative populations with total hip or knee replacement for the treatment of osteoarthritis reporting proportions of people by pain intensity.

DATA SOURCES:

MEDLINE and EMBASE databases searched to January 2011 with no language restrictions. Citations of key articles in ISI Web of Science and reference lists were checked.

STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS:

Prospective studies of consecutive, unselected osteoarthritis patients representative of the primary total hip or knee replacement population, with intensities of patient-centred pain measured after 3 months to 5-year follow-up.

STUDY APPRAISAL AND SYNTHESIS METHODS:

Two authors screened titles and abstracts. Data extracted by one author were checked independently against original articles by a second. For each study, the authors summarised the proportions of people with different severities of pain in the operated joint.

RESULTS:

Searches identified 1308 articles of which 115 reported patient-centred pain outcomes. Fourteen articles describing 17 cohorts (6 with hip and 11 with knee replacement) presented appropriate data on pain intensity. The proportion of people with an unfavourable long-term pain outcome in studies ranged from about 7% to 23% after hip and 10% to 34% after knee replacement. In the best quality studies, an unfavourable pain outcome was reported in 9% or more of patients after hip and about 20% of patients after knee replacement.

LIMITATIONS:

Other studies reported mean values of pain outcomes. These and routine clinical studies are potential sources of relevant data.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS:

After hip and knee replacement, a significant proportion of people have painful joints. There is an urgent need to improve general awareness of this possibility and to address determinants of good and bad outcomes.

PMID:

 

22357571

 

[PubMed] 

PMCID:

 

PMC3289991

 

Free PMC Article