The predictive significance of bone mineral density on postoperative pain relief in knee osteoarthritis patients after total knee arthroplasty: A prediction model |
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Authors: | Yuanqiang Li Yunsheng Ou Yong Zhu Zenghui Zhao Bin He Shuai Xu Haoyang Yu |
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Affiliation: | 1. Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Youyi Road No. 1, Chongqing 400016, China;2. Chongqing Sports Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road No. 1, Chongqing 400016, China;1. Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, 30-1 Oyaguchikamimati, Itabashi-ku, Tokyo, 173-8610, Japan;2. Department of Orthopaedic Surgery, Sonoda Medical Institute Tokyo Spine Center, 2-5-10 Ikohoncyo Adati-ku, Tokyo, 121-0807, Japan;1. Department of Orthopaedic Surgery, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka 020-0066, Japan;2. Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;3. Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Tatutayashiki, Izumi-ku, Sendai 981-3217, Japan;4. Department of Orthopaedic Surgery, Miyagi South Medical Center, 38-1 Aza-nishi, Ogawara, Shibata-gun, Sendai 989-1253, Japan;5. Department of Orthopaedic Surgery, JR Sendai Hospital, 131 Itsutsubashi, Aoba-ku, Sendai 980-8508, Japan;1. Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran;2. College of Medicine, University of Al-Kufa, Kufa, Najaf, Iraq;1. Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan;3. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan;5. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate school of Medicine, Tokyo, Japan;1. Department of Othopaedic and Spine Surgery, Fukuoka Children''s Hospital, 5-1-1 Kashii Teriha, Higashi-ku, Fukuoka 812-0017, Japan;2. Department of Othopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;3. Department of Othopaedic Surgery, Saga Handicapped Children''s Hospital, 2215-27 Kinryu, Kinryu-machi, Saga 849-0906, Japan;1. Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Aichi, Japan;2. Department of Spine and Spinal Cord, Fujita Health University, Aichi, Japan;3. Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan |
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Abstract: | BackgroundBone mineral density (BMD) may be an important factor affecting the clinical outcomes after total knee arthroplasty (TKA). However, further information regarding BMD in postoperative pain relief is not present yet. This study aims to gain further insight into the predictive significance of BMD in postoperative pain relief in knee osteoarthritis (KOA) patients after TKA.Methods156 KOA patients treated by TKA were included in this study. Visual analogue scale (VAS) was used to measure the pain intensity in patients within one year after TKA. The patients were divided into good pain relief group (the improvement of VAS ≥ 3) and poor pain relief group (the improvement of VAS < 3). BMD and other clinical characteristics were also collected. Logistic regression analysis and receiver operating characteristic curve (ROC curve) were used to evaluate the predictive significance of BMD. Subgroup analysis was used to compare the difference of postoperative pain between High BMD group and Low BMD group extra.Results34 (21.8%) patients had poor pain relief after TKA. Logistic regression analysis indicated that age, BMD, preoperative hospital for special surgery (HSS) scores, preoperative VAS score and postoperative posterior slope angles (PSA) were the risk factors of poor pain relief (P < 0.05). Using BMD as a predictor, the optimum cut-off value of poor pain relief was T-level = ?3.0 SD in the ROC curve, where sensitivity and specificity were 73.5% and 83.7%, respectively. Based on this cut-off value, obvious pain relief was observed in the High BMD group compared with Low BMD group from the 6th month after TKA in the subgroup analysis (P < 0.05).ConclusionsBMD is an effective predictor for postoperative pain relief in KOA patients after TKA, and the poor pain relief should be fully considered especially when BMD T-level ≤ ?3.0 SD. |
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