PMID- 23707268
OWN - NLM
STAT- MEDLINE
DCOM- 20140321
LR  - 20220311
IS  - 1872-6623 (Electronic)
IS  - 0304-3959 (Linking)
VI  - 154
IP  - 9
DP  - 2013 Sep
TI  - Widespread sensitization in patients with chronic pain after revision total knee 
      arthroplasty.
PG  - 1588-1594
LID - 10.1016/j.pain.2013.04.033 [doi]
AB  - Pain and sensitization are major issues in patients with osteoarthritis both 
      before and after total knee arthroplasty (TKA) and revision TKA (re-TKA). The aim 
      of this study was to assess sensitization in patients with and without chronic 
      pain after re-TKAs. Twenty patients with chronic knee pain and 20 patients 
      without pain after re-TKA participated. Spreading of pain was evaluated as the 
      number of pain sites using a region-divided body chart. The pressure pain 
      threshold (PPT) and pressure pain tolerance (PTT) were assessed by cuff algometry 
      at the lower leg. Temporal summation of pain was assessed by recordings of the 
      pain intensity on a visual analog scale (VAS) during repeated cuff pressure 
      stimulations. Conditioning pain modulation (CPM) was recorded by experimental 
      tonic arm pain by cuff pressure stimulation and assessment of PPTs on the knee, 
      leg, and forearm using handheld pressure algometry. Participants with pain after 
      re-TKA compared to participants without pain demonstrated: (1) significantly more 
      pain sites (P=.004), (2) decreased cuff PPTs and PTTs at the lower leg (P<.001), 
      (3) facilitated temporal summation (P<.001), and (4) impaired CPM (P<.001). 
      Additionally, significant correlations between knee pain intensity and cuff PPTs, 
      temporal summation, and CPM and between total duration of knee pain and temporal 
      summation were found (P<.05). This study demonstrated widespread sensitization in 
      patients with pain after re-TKA and highlighted the importance of ongoing 
      nociceptive input for the chronification process. This has important implications 
      for future revisions, and precautions should be taken if patients have widespread 
      sensitization.
CI  - Copyright (c) 2013 International Association for the Study of Pain. Published by 
      Elsevier B.V. All rights reserved.
FAU - Skou, Soren Thorgaard
AU  - Skou ST
AD  - Orthopaedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark 
      Center for Sensory-Motor Interaction (SMI), Department of Health Science and 
      Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
FAU - Graven-Nielsen, Thomas
AU  - Graven-Nielsen T
FAU - Rasmussen, Sten
AU  - Rasmussen S
FAU - Simonsen, Ole H
AU  - Simonsen OH
FAU - Laursen, Mogens B
AU  - Laursen MB
FAU - Arendt-Nielsen, Lars
AU  - Arendt-Nielsen L
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130420
PL  - United States
TA  - Pain
JT  - Pain
JID - 7508686
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Arm/innervation
MH  - Arthroplasty, Replacement, Knee/*methods
MH  - Chronic Pain/etiology/*psychology/*surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis/complications
MH  - Pain Measurement
MH  - Pain Threshold/*physiology
MH  - Pressure
MH  - Statistics as Topic
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - Cuff algometry
OT  - Experimental pain
OT  - Knee osteoarthritis
OT  - Pain mechanisms
OT  - Pressure algometry
OT  - Reoperation
OT  - Spreading of pain
OT  - Spreading sensitization
EDAT- 2013/05/28 06:00
MHDA- 2014/03/22 06:00
CRDT- 2013/05/28 06:00
PHST- 2013/02/15 00:00 [received]
PHST- 2013/04/10 00:00 [revised]
PHST- 2013/04/17 00:00 [accepted]
PHST- 2013/05/28 06:00 [entrez]
PHST- 2013/05/28 06:00 [pubmed]
PHST- 2014/03/22 06:00 [medline]
AID - 00006396-201309000-00015 [pii]
AID - 10.1016/j.pain.2013.04.033 [doi]
PST - ppublish
SO  - Pain. 2013 Sep;154(9):1588-1594. doi: 10.1016/j.pain.2013.04.033. Epub 2013 Apr 
      20.