title: Prevalence and Predictive Factors of Chronic Postsurgical Pain and Global Surgical Recovery 1 Year After Outpatient Knee Arthroscopy: A Prospective Cohort Study.
abstract: Outpatient knee arthroscopy is one of the most commonly performed surgical procedures. Previous research has demonstrated that chronic postsurgical pain (CPSP) after outpatient surgery is prevalent. Our objective was to determine the prevalence and predictive factors of CPSP and Global Surgical Recovery (GSR) 1 year after knee arthroscopy.A prospective longitudinal cohort study was performed. Patients were included during an 18-month period. Data were collected by using 3 questionnaires: at 1 week preoperatively, 4 days postoperatively, and 1 year postoperatively. A value of >3 on an 11-point numeric rating scale (NRS) was defined as moderate to severe pain. A score of ≤80% on the Global Surgical Recovery Index was defined as poor GSR. Stepwise logistic regression analysis was performed to determine which variables were predictors for CPSP and poor GSR.The prevalence of moderate to severe preoperative pain in patients undergoing knee arthroscopy (n = 104) was 71.2%, of acute postsurgical pain 37.5%, and of CPSP 32.7%. Risk factors for CPSP were the presence of preoperative pain and preoperative analgesic use, with odds ratios of 6.31 (1.25-31.74) and 4.36 (1.58-12.07), respectively. The prevalence of poor GSR 1 year after outpatient knee arthrosocpy was 50.0%. Poor GSR 4 days after the surgery was a risk factor with an odds ratio of 8.38 (0.92-76.58) and quality of life 4 days after surgery was a protective factor with and odds ratio of 0.10 (0.02-0.64).Both CPSP and poor GSR are common 1 year after knee arthroscopy. Patients at risk for CPSP can be identified during the preoperative phase. Prediction of poor GSR 1 year after surgery is mainly related to early postoperative recovery.
authors.affiliation: From the Department of Anesthesiology and Pain Treatment (DMNH, AAAF, EAJ, H-FG, MAEM, WFFAB); Department of Orthopedic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands (PJE); and Department of Anesthesiology, ICU and Perioperative Medicine, Hamad Medical Corporation, Qatar (MAEM).
authors.forename: Daisy M N
authors.initials: DMN
authors.lastname: Hoofwijk
authors.forename: Audrey A A
authors.initials: AAA
authors.lastname: Fiddelers
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Emans
authors.forename: Elbert A
authors.initials: EA
authors.lastname: Joosten
authors.forename: Hans-Fritz
authors.initials: HF
authors.lastname: Gramke
authors.forename: Marco A E
authors.initials: MAE
authors.lastname: Marcus
authors.forename: Wolfgang F F A
authors.initials: WFFA
authors.lastname: Buhre
mesh_terms: D000328:Adult; D000367:Age Factors; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods*; D059350:Chronic Pain; D005260:Female; D006801:Humans; D007719:Knee Joint; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010045:Outpatients; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors