Prevalence and Predictive Factors of Chronic Postsurgical Pain and Global Surgical Recovery 1 Year After Outpatient Knee Arthroscopy: A Prospective Cohort Study

Daisy M N Hoofwijk, Audrey A A Fiddelers, Peter J Emans, Elbert A Joosten, Hans-Fritz Gramke, Marco A E Marcus, Wolfgang F F A Buhre, Daisy M N Hoofwijk, Audrey A A Fiddelers, Peter J Emans, Elbert A Joosten, Hans-Fritz Gramke, Marco A E Marcus, Wolfgang F F A Buhre

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.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Presence of chronic postsurgical pain (CPSP) versus the severity of osteoarthritis according to the Outerbridge Classification. CPSP = chronic postsurgical pain, NRS = numeric rating scale, OA = osteoarthritis.
FIGURE 2
FIGURE 2
Presence of poor global surgical recovery (GSR) versus the severity of osteoarthritis according to the Outerbridge Classification. GSR = global surgical recovery, OA = osteoarthritis.

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Source: PubMed

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