Chronic pain following total hip arthroplasty: a nationwide questionnaire study.
BACKGROUND
Chronic post-operative pain is a well-recognized problem after various types of surgery, but little is known about chronic pain after orthopedic surgery. Severe pre-operative pain is the primary indication for total hip arthroplasty (THA). Therefore, we examined the prevalence of chronic pain after THA in relation to pre-operative pain and early post-operative pain.


METHODS
A questionnaire was sent to 1231 consecutive patients who had undergone THA 12-18 months previously, and whose operations had been reported to the Danish Hip Arthroplasty Registry.


RESULTS
The response rate was 93.6%. Two hundred and ninety-four patients (28.1%) had chronic ipsilateral hip pain at the time of completion of the questionnaire, and pain limited daily activities to a moderate, severe or very severe degree in 12.1%. The chronic pain state was related to the recalled intensity of early post-operative pain [95% confidence interval (CI), 20.4-33.4%] and pain complaints from other sites of the body (95% CI, 20.7-32.1%), but not to the pre-operative intensity of pain.


CONCLUSIONS
Chronic pain after THA seems to be a significant problem in at least 12.1% of patients. Our results suggest that genetic and psychosocial factors are important for the development of chronic post-THA pain.
Nikolajsen
L
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Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark. nikolajsen@dadlnet.dk
Brandsborg
B
B
Lucht
U
U
Jensen
T S
TS
Kehlet
H
H
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires