title: Pre-operative Predictive Factors of Post-operative Pain in Patients With Hip or Knee Arthroplasty: A Systematic Review.
abstract: OBJECTIVE
  To analyze pre-surgical predictive factors of post-surgical pain in patients undergoing hip or knee arthoplasty.
  
  
  METHODS
  A systematic literature review was performed. We defined a sensitive strategy on Medline, Embase and Cochrane Library up to May 2013. The inclusion criteria were: patients undertaking knee and/or hip arthroplasty, adults with moderate or severe pain (≥4 on a Visual Analog Scale) in whom predictive factors of post-surgical pain were evaluated before surgery. Systematic reviews, meta-analyses, controlled trials and observational studies were selected. We excluded animals and basic science articles, reviews of prosthesis, prosthesis due to fractures, patients with rheumatic diseases or studies with mixed population in which disaggregated data was not possible to obtain.
  
  
  RESULTS
  A total 37 articles of moderate quality were selected. The articles included representative patients undergoing a knee or hip arthroplasty in our country; most of them were aged 60 years or above, with osteoarthritis, and with a high rate of obesity and comorbidities. We found great variability regarding the type of studies and predictive factors. There was a strong association between post-surgical pain and the following pre-surgical factors: female gender, low socio-economic status, higher pain, comorbidities, low back pain, poor functional status, and psychological factors (depression, anxiety or catastrophic pain).
  
  
  CONCLUSIONS
  There are pre-surgical factors that might influence post-surgical pain in patients undergoing a knee or hip arthroplasty. Therefore, they should be taken into account when considering an arthroplasty.
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del dolor, Hospital Clínic de Barcelona, Barcelona, España.
authors.forename: Clara
authors.initials: C
authors.lastname: Hernández
authors.affiliation: Unidad de Hombro y Codo. Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: Jorge
authors.initials: J
authors.lastname: Díaz-Heredia
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Virgen de la Macarena, Sevilla, España.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Berraquero
authors.affiliation: Unidad de Hombro y Codo. Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: Crespo
authors.affiliation: Instituto de Salud Musculoesquelética, Madrid, España.
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Loza
authors.affiliation: Unidad de Hombro y Codo. Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: drmri@hotmail.com.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Ruiz Ibán
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D057234:Preoperative Period; D018570:Risk Assessment; D012307:Risk Factors
keywords: Artroplastia de cadera; Artroplastia de rodilla; Dolor; Factor predictivo; Hip arthroplasty; Knee arthroplasty; Pain; Predictive factor