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Núñez-Cortés R1,2, Ortega Palavecinos M2, Mattar Toro G2, Besoaín Saldaña Á1, Cruz-Montecinos C1,3,4
1University of Chile, Department of Physical Therapy, Faculty of Medicine, Santiago, Chile, 2Hospital Cínico La Florida, Santiago, Chile, 3University of Valencia, Physical Therapy Department, Valencia, Spain, 4San José Hospital, Biomechanics and Kinesiology Laboratory, Santiago, Chile
Background: Chronic postsurgical pain (CPSP), defined as moderate to severe pain lasting at least 3 months following surgery. The prevalence of this phenomenon in patients undergoing Total Knee Arthroplasty (TKA) ranges from 13-40% and has a negative impact on the activities of daily life and the quality of life of patients. This condition should be considered a serious health problem, as the prolonged use of opioids and adjuvant analgesics following operation can result in dependence and addiction in this patients, increasing the economic costs in this population.
Purpose: Analyze relationship between Social Determinants of Health in patient with CPSP after TKA.
Methods: An observational cross-sectional study was performed in 58 patients undergoing TKA in a public hospital in Chile, these patients were included three to twelve months after surgery. Subjects were categorized into two groups: with CPSP (n=22) or without CPSP (n=36) according to whether they had more than 40 points on the visual analog scale after three months of surgery. Sociodemographic variables related to structural determinants of health were associated to clinical outcomes: Sex (Male/Female); Age (less than 65 years old / over 65 years old); Body mass index (Normal or overweight / Obesity); Educational level (Basic / Middle or higher); Monetary Income (less than 388 USD / greater than 388 USD) and Comorbidities (without alterations / systemic diseases). The statistical analysis was performed with the Chi-square test, using the two-way contingency table method.
Results: 58 individuals (21 male and 37 female) were evaluated. The median age of participants was 69 years (interquartile range 54-81) and the median duration of their symptoms was 6 months (interquartile range 4-10). Significant differences were found for the educational level when comparing patients with or without CPSP, 22.4% of patients with CPSP had a low level of education compared to 19% of patients without CPSP. In addition, 15.5% of patients with CPSP had a medium or higher level of education compared to 43.1% of patients without CPSP (p=0.03). There were no differences for the other categories.
Conclusion(s): The results in our study indicate that 37.9% of patients developed CPSP after TKA. We found that patients with persistent pain after surgery had a lower educational level compared to patients without persistent pain. Future studies should consider whether this condition is related to functional tests or psychosocial variables in this population.
Implications: We recommended to identify the educational level of patients and develop directed education and counseling strategies prior to surgery in patients with low educational level. Future studies should investigate how the level of education can affect pain.
Keywords: Educational Status, postsurgical pain, total knee replacement.
Funding acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Purpose: Analyze relationship between Social Determinants of Health in patient with CPSP after TKA.
Methods: An observational cross-sectional study was performed in 58 patients undergoing TKA in a public hospital in Chile, these patients were included three to twelve months after surgery. Subjects were categorized into two groups: with CPSP (n=22) or without CPSP (n=36) according to whether they had more than 40 points on the visual analog scale after three months of surgery. Sociodemographic variables related to structural determinants of health were associated to clinical outcomes: Sex (Male/Female); Age (less than 65 years old / over 65 years old); Body mass index (Normal or overweight / Obesity); Educational level (Basic / Middle or higher); Monetary Income (less than 388 USD / greater than 388 USD) and Comorbidities (without alterations / systemic diseases). The statistical analysis was performed with the Chi-square test, using the two-way contingency table method.
Results: 58 individuals (21 male and 37 female) were evaluated. The median age of participants was 69 years (interquartile range 54-81) and the median duration of their symptoms was 6 months (interquartile range 4-10). Significant differences were found for the educational level when comparing patients with or without CPSP, 22.4% of patients with CPSP had a low level of education compared to 19% of patients without CPSP. In addition, 15.5% of patients with CPSP had a medium or higher level of education compared to 43.1% of patients without CPSP (p=0.03). There were no differences for the other categories.
Conclusion(s): The results in our study indicate that 37.9% of patients developed CPSP after TKA. We found that patients with persistent pain after surgery had a lower educational level compared to patients without persistent pain. Future studies should consider whether this condition is related to functional tests or psychosocial variables in this population.
Implications: We recommended to identify the educational level of patients and develop directed education and counseling strategies prior to surgery in patients with low educational level. Future studies should investigate how the level of education can affect pain.
Keywords: Educational Status, postsurgical pain, total knee replacement.
Funding acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Topic: Musculoskeletal: lower limb; Pain & pain management
Ethics approval required: Yes
Institution: Hospital Clínico la Florida
Ethics committee: Comité de Ética Servicio de Salud Metropolitano Sur Oriente
Ethics number: RN0042018
All authors, affiliations and abstracts have been published as submitted.
