PDF(Pubmed)
Abstract：
BACKGROUND: There is a lack of relevant studies to grade the evidence on the risk factors of chronic pain after total knee arthroplasty (TKA), and only quantitative methods are used for systematic evaluation. The review aimed to systematically identify risk factors of chronic postoperative pain following TKA and to evaluate the strength of the evidence underlying these correlations.
METHODS: PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched from initiation to September 2023. Cohort studies, case-control studies, and cross-sectional studies involving patients undergoing total knee replacement were included. A semi-quantitative approach was used to grade the strength of the evidence-based on the number of investigations, the quality of the studies, and the consistency of the associations reported by the studies.
RESULTS: Thirty-two articles involving 18,792 patients were included in the final systematic review. Ten variables were found to be strongly associated with postoperative pain, including Age, body mass index (BMI), comorbidities condition, preoperative pain, chronic widespread pain, preoperative adverse health beliefs, preoperative sleep disorders, central sensitization, preoperative anxiety, and preoperative function. Sixteen factors were identified as inconclusive evidence.
CONCLUSIONS: This systematic review clarifies which risk factors could be involved in future research on TKA pain management for surgeons and patients. It highlights those factors that have been controversial or weakly correlated, emphasizing the need for further high-quality studies to validate them. Most crucially, it can furnish clinicians with vital information regarding high-risk patients and their clinical attributes, thereby aiding in the development of preventive strategies to mitigate postoperative pain following TKA.
BACKGROUND: This systematic review has been registered on the PROSPERO platform (CRD42023444097).
METHODS: PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched from initiation to September 2023. Cohort studies, case-control studies, and cross-sectional studies involving patients undergoing total knee replacement were included. A semi-quantitative approach was used to grade the strength of the evidence-based on the number of investigations, the quality of the studies, and the consistency of the associations reported by the studies.
RESULTS: Thirty-two articles involving 18,792 patients were included in the final systematic review. Ten variables were found to be strongly associated with postoperative pain, including Age, body mass index (BMI), comorbidities condition, preoperative pain, chronic widespread pain, preoperative adverse health beliefs, preoperative sleep disorders, central sensitization, preoperative anxiety, and preoperative function. Sixteen factors were identified as inconclusive evidence.
CONCLUSIONS: This systematic review clarifies which risk factors could be involved in future research on TKA pain management for surgeons and patients. It highlights those factors that have been controversial or weakly correlated, emphasizing the need for further high-quality studies to validate them. Most crucially, it can furnish clinicians with vital information regarding high-risk patients and their clinical attributes, thereby aiding in the development of preventive strategies to mitigate postoperative pain following TKA.
BACKGROUND: This systematic review has been registered on the PROSPERO platform (CRD42023444097).
摘要：
背景：缺乏相关研究来对全膝关节置换术（TKA）后慢性疼痛的危险因素进行分级，只有定量的方法才能进行系统评价。该综述旨在系统地确定TKA术后慢性疼痛的危险因素，并评估这些相关性的证据强度。
方法：PubMed，WebofScience,科克伦图书馆,Embase,和CINAHL数据库从开始到2023年9月进行搜索。队列研究，病例对照研究，纳入全膝关节置换术患者的横断面研究.采用半定量的方法对证据的强度进行分级——根据调查的数量，研究的质量，以及研究报告的关联的一致性。
结果：最终的系统评价包括32篇文章，涉及18,792例患者。发现十个变量与术后疼痛密切相关，包括年龄,体重指数（BMI），合并症状况，术前疼痛,慢性广泛性疼痛，术前不良健康信念，术前睡眠障碍，中央敏化，术前焦虑,和术前功能。16个因素被确定为不确定的证据。
结论：本系统综述阐明了哪些风险因素可能参与未来外科医生和患者TKA疼痛管理的研究。它突出了那些有争议或弱相关的因素，强调需要进一步的高质量研究来验证它们。最关键的是,它可以为临床医生提供有关高危患者及其临床特征的重要信息，从而帮助制定预防策略以减轻TKA术后疼痛。
背景：该系统综述已在PROSPERO平台（CRD42023444097）上注册。
方法：PubMed，WebofScience,科克伦图书馆,Embase,和CINAHL数据库从开始到2023年9月进行搜索。队列研究，病例对照研究，纳入全膝关节置换术患者的横断面研究.采用半定量的方法对证据的强度进行分级——根据调查的数量，研究的质量，以及研究报告的关联的一致性。
结果：最终的系统评价包括32篇文章，涉及18,792例患者。发现十个变量与术后疼痛密切相关，包括年龄,体重指数（BMI），合并症状况，术前疼痛,慢性广泛性疼痛，术前不良健康信念，术前睡眠障碍，中央敏化，术前焦虑,和术前功能。16个因素被确定为不确定的证据。
结论：本系统综述阐明了哪些风险因素可能参与未来外科医生和患者TKA疼痛管理的研究。它突出了那些有争议或弱相关的因素，强调需要进一步的高质量研究来验证它们。最关键的是,它可以为临床医生提供有关高危患者及其临床特征的重要信息，从而帮助制定预防策略以减轻TKA术后疼痛。
背景：该系统综述已在PROSPERO平台（CRD42023444097）上注册。
