Timing of arthroplasty, what is the influence of nocturnal pain and pain at rest on the outcome?
OBJECTIVE
The purpose of this study was to investigate whether nocturnal pain and pain at rest preoperatively influence the satisfaction in patients after joint arthroplasty. The second research question is whether subjective outcome (VAS/WOMAC) after hip (THA) or knee arthroplasty (TKA) differs in patients with or without nocturnal pain and pain at rest preoperatively compared to those who do not.


METHODS
A consecutive group of 189 TKAs and 189 THAs was evaluated. The influence of pain at rest and nocturnal pain preoperatively on the outcome was evaluated by means of a one-way ANOVA. Outcome measurements used were WOMAC, VAS pain and VAS Satisfaction.


RESULTS
The results show that satisfaction at follow up was not influenced by the presence of nocturnal pain or pain at rest preoperatively. The presence of nocturnal pain and pain at rest preoperatively did result in a poorer WOMAC pain score WOMAC physical impairment score and a higher VAS pain at rest and activity after surgery for both THA and TKA.


CONCLUSIONS
The results show that the presence of pain at night and pain at rest in symptomatic osteoarthritic patients results in worse VAS and WOMAC scores, but with similar amounts of satisfaction at follow up.
Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, The Netherlands, Daniel@drhaverkamp.com.
Daniël
D
Haverkamp
Roy B G
RB
Brokelman
Corne J M
CJ
van Loon
Albert
A
van Kampen
D000368:Aged; D018771:Arthralgia / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D017060:Patient Satisfaction; D016896:Treatment Outcome