scholarly journals Pain at Rest as a Predictive Factor of Chronic Pain Related to Central Sensitization in Patients With Hip Osteoarthritis

2020 ◽  
Author(s):  
Yoshihisa Ohashi ◽  
Kensuke Fukushima ◽  
Gen Inoue ◽  
Kentaro Uchida ◽  
Tomohisa Koyama ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Score ◽  
Predictive Factor ◽  
Central Sensitization ◽  
Hip Osteoarthritis ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Knee Oa ◽  
The Mean ◽  
Pain At Rest

Abstract Background Central sensitization (CS) has been identified as a factor that induces chronic pain in patients with osteoarthritis (OA). Although there are some reports of CS in knee OA, studies on CS in hip OA are lacking. We aimed to evaluate chronic pain related to CS in patients with hip OA using the CS Inventory (CSI). Additionally, we aimed to clarify the characteristics of patients with pain related to CS. Methods A total of 100 patients scheduled to undergo total hip arthroplasty (THA) for hip OA were retrospectively reviewed. We investigated the CSI score as an assessment of the extent to which the patients had pain related to CS. Additionally, we assessed the relationships between the CSI score and clinical factors, including age, duration of pain, degree of pain at rest and on activity, by using the visual analogue scale (VAS) and the Harris Hip Score. Results The mean CSI score was 19.54 ± 11.25 points. Twenty-one percent of the patients with a score of ≥ 30 were diagnosed as having chronic pain related to CS. The CSI score correlated significantly only with the VAS pain score at rest (r = 0.348, P < 0.001). Fifteen patients were diagnosed with CS syndromes (CSSs) in the assessment of CSI Part B. The mean CSI score was significantly higher in patients diagnosed with CSSs (30.00 ± 12.50) than in patients without a CSS (17.70 ± 10.00; P < 0.001). Conclusion Twenty-one percent of the patients scheduled to undergo THA for hip OA were diagnosed with chronic pain related to CS, which might influence the clinical results after THA. As the VAS pain score at rest was significantly correlated with the CSI score, pain at rest might be a predictive factor of chronic pain related to CS in patients with hip OA.

scholarly journals Central Sensitization Inventory scores correlate with pain at rest in patients with hip osteoarthritis: A retrospective study

2020 ◽  
Author(s):  
Yoshihisa Ohashi ◽  
Kensuke Fukushima ◽  
Gen Inoue ◽  
Kentaro Uchida ◽  
Tomohisa Koyama ◽  
...  
Keyword(s):  
Central Sensitization ◽  
Structural Changes ◽  
Hip Osteoarthritis ◽  
Hip Pain ◽  
Harris Hip Score ◽  
Poor Correlation ◽  
Clinical Tool ◽  
Number Of Patients ◽  
The Mean ◽  
Pain At Rest

Abstract Background: Patients with persistent pain due to osteoarthritis (OA) complain of multiple symptoms that cannot be explained solely by structural changes. A poor correlation exists between structural and inflammatory changes in OA and pain levels. Central sensitization (CS) has been identified as a factor that induces chronic pain in patients with OA. Although it is important to identify osteoarthritis patients with CS components, the prevalence and characteristics of CS, especially those in patients with hip OA, are not well understood. Thus, we aimed to determine the prevalence and characteristics of CS in patients with hip OA, in this study. Methods: The CS Inventory (CSI), used as a non-invasive routine clinical tool to evaluate the presence of CS 1 month before surgery in 100 patients with hip OA, was measured at our outpatient clinic, and the data were retrospectively reviewed. We determined the number of patients with a CSI score of 40 points or higher and assessed the relationships between the CSI score and clinical factors (including age, duration of hip pain, degree pain at rest and on activity, by using the visual analogue scale [VAS] and the Harris Hip Score) using the Spearman’s correlation coefficient. Results: The mean age of participants was 63.9±11.6 years, and there were 15 men and 85 women. All patients had hip OA, categorised as advanced and terminal stage (Tönnis grade 2–3) on preoperative plain radiography. The mean duration of hip pain was 4.2±4.4 years. The mean CSI score was 19.5±11.3 and 5 (5.0%) of the patients had a score of 40 or more points. CSI scores correlated significantly only with VAS pain at rest (r=0.348, P<0.001). Conclusion: In this study, 1 out of every 20 hip OA patients had CS components. CSI scores were significantly correlated with pain at rest in hip OA patients. CS approaches to hip OA may be one of the treatment options for pain at rest.

scholarly journals Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Afshin Taheriazam ◽  
Amin Saeidinia
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Superficial Infection ◽  
Total Hip ◽  
One Stage ◽  
The Mean ◽  
Hardinge Approach

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.

Good mid-term clinical results of a cemented dual mobility cup: a single-centre experience

2017 ◽  
Vol 28 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Gregor Kavčič ◽  
Pika Mirt ◽  
Klemen Bedenčič
Keyword(s):  
Final Analysis ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Single Centre Experience ◽  
The Mean ◽  
Hip Arthroplasties

Introduction and methods: From January 2004 to December 2008, 188 total hip arthroplasties were performed using a cemented dual mobility cup. 174 patients were available for final analysis. Their mean age was 76.8 (range 54-98 years). The mean follow-up was 7.7 years (range 5-10 years). Results: There were no dislocations. Survivorship rates of the femoral and acetabular components were 100% at a minimum of 5 years. At the latest follow-up, the mean Harris Hip Score significantly increased from 31.6 (only arthritic patients) points preoperatively to 84.5 points. No patients had progressive osteolysis, component migration, or loosening on radiographs. 2 patients presented with periprosthetic fractures treated conservatively. 2 patients presented with infection treated without implant removal and 1 patient presented with transient femoral palsy. Conclusions: The results of this consecutive series confirmed the good performance of the cemented dual mobility cup at mean 7.7 years follow-up with no revision and no dislocations.

scholarly journals The Early Outcome Of the Bernese Periacetabular Osteotomy For Hip Dysplasia In Multiple Epiphyseal Dysplasia

2021 ◽  
Author(s):  
Yao-Yuan Chang ◽  
Chia-Che Lee ◽  
Sheng-Chieh Lin ◽  
Ken N Kuo ◽  
Kuan-Wen Wu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Statistical Significance ◽  
Periacetabular Osteotomy ◽  
Hip Osteoarthritis ◽  
Multiple Epiphyseal Dysplasia ◽  
Harris Hip Score ◽  
Joint Preserving Surgery ◽  
The Mean ◽  
Epiphyseal Dysplasia

Abstract Background:Multiple epiphyseal dysplasia (MED) is a rare congenital bone dysplasia. Patients with MED develop secondary hip osteoarthritis as early as third to the fourth decade. Currently, there is no consensus on how to prevent or slow the process of secondary hip osteoarthritis.The Bernese periacetabular osteotomy is a joint preserving surgery to reshape acetabulum and extend coverage for the hip, however, there is no established evidence of the effectiveness for the MED hips.Patients and methods:A retrospective series of 6 hips in 3 patients with multiple epiphyseal dysplasia treated with the Bernese periacetabular osteotomy were reviewed. The average age at the time of surgery was 14.3 years (range: 11.4 to 17.2 y). Radiographic parameters were analyzed preoperatively and 1-year postoperatively. The hip function was evaluated by the Harris Hip Score (HHS) before and after surgery. Results:The mean follow-up time was 1.7 years. The mean LCEA increased from 3.8° to 47.1° (p = .02), ACEA increased from 7.3° to 35.1° (p = .02), and AI decreased from 27.8° to 14.6° (p=.04). The femoral head coverage ratio increased from 66.8% to 100% (p= .02). The procedure achieved femoral head medialization by decreasing central head distance from 86.7mm preoperatively to 82.7mm postoperatively, however, without statistical significance. (p = .699). The improvement of clinical outcomes by mean HHS was significant from 67.3 preoperatively to 86.7 postoperatively (p=0.05).Conclusion:Bernese PAO is a feasible option for treatment of the hip problems in MED patients. It reshapes acetabular and femoral morphology 3-dimensionally. In our study, the short-term follow-up results showed obvious functional and radiographic improvement. A long-term follow-up is necessary in the future.

scholarly journals Pain, Stress and Anxiety of Chronic Pain Patients Prior to, During and After Political Turmoil in Thailand

2018 ◽  
Vol 36 (4) ◽  
pp. 291
Author(s):  
Sasikaan Nimmaanrat
Keyword(s):  
Chronic Pain ◽  
Pain Score ◽  
Pain Clinic ◽  
P Value ◽  
Military Dictatorship ◽  
Chronic Pain Patients ◽  
The Mean ◽  
Stress Score ◽  
Political Turmoil ◽  
Pain Patients

Objective: Thailand was plagued with serious political turmoil for many years. We would like to know whether this turmoil has had an impact on our chronic pain patients in terms of intensity of pain, stress and anxiety, as well as daily living and sleep.Material and Methods: Patients with at least 3 months of pain prior to 31 October 2013 (the date that the demonstrations started) were enrolled in this study. The data were collected from the patients who attended our pain clinic from December 2014 to May 2015. The patients were asked to complete a questionnaire on their severity of pain, stress and anxiety for the 3 different stages: prior to the demonstrations (period 1), during the demonstrations (period 2) and under military dictatorship or after the demonstrations (period 3).Results: There were 120 patients, 49 males (40.8%) and 71 females (59.2%). The mean age was 56.3±15.8 years old (range 18-88). The majority were Buddhist (108 patients, 90.0%) while 11 patients (9.2%) were Muslim and 1 patient (0.8%) was Christian. The mean duration of pain prior to the beginning of the demonstrations was 62.8 months (range 3-324 months). Regarding the pain score, the mean maximum pain score was significantly different between periods 1 (8), 2 (7.7) and 3 (6.8) (p-value<0.001). Regarding the anxiety score, the mean maximum anxiety score was significantly different between periods 1 (3.8), 2 (4.8) and 3 (2.9) (p-value=0.03). Regarding the stress score, the mean maximum stress score was significantly different between periods 1 (3.8), 2 (4.4) and 3 (2.8) (p-value=0.02). Using multiple logistic regression analysis, no factors (gender, age, religious, duration of pain and levels of anxiety and stress) were found to have contributed to the reduction of pain intensity.Conclusion: The demonstrations during the political turmoil did not increase the severity of pain but led to higher levels of stress and anxiety. On the other hand, under the military dictatorship, lower pain scores as well as stress and anxiety levels in chronic pain patients attending our pain clinic have been found.

The Use of Basket and Cross Shell Reinforcement in Revision Acetabulum Arthroplasty

2018 ◽  
Vol 20 (2) ◽  
pp. 123-131
Author(s):  
Andrzej Pozowski ◽  
Mateusz Kowal ◽  
Patryk Pozowski ◽  
Małgorzata Paprocka-Borowicz
Keyword(s):  
Average Duration ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Acetabular Bone ◽  
Huge Data ◽  
Biological Capacity ◽  
The Mean ◽  
Revision Operations ◽  
Basic Prerequisite

Background. In spite of many decades of experience and huge data resources to evaluate the results of increasingly difficult and extensive acetabulum revision operations, it is not possible to obtain fully satisfactory results. This article presents the indications for use, surgical technique, and distant and intermediate-range results in the operation of replacing a loosened acetabular component of an endoprosthesis with accompanying extensive cavitary or segmental floor defects. Material and methods. A retrospective evaluation was performed on 65 hips in 55 patients, including bila­teral procedures in 8 women and 2 men, operated on between 1994 and 2012. The mean age of the patients at the time of surgery was 66 +/- 16 years. The average duration of follow-up was 9 years and 3 months. Results. Clinical results at 36 months from the surgery showed that the Harris Hip Score had increased by a mean of 47.2 HHS points and the WOMAC index had increased by 37.7 points. Conclusions. 1. The use of the method described in the article in selected cases produces good and excellent results, especially with the use of double reinforcement. 2. A basic prerequisite for the use of the basket is stable support for at least 3 arms of the basket on the acetabular bone reinforcement ring and good protection of grafts in the bone stock with sufficient biological capacity.

Medial Placement of a Cementless Acetabular Component in a Modern Alumina-on-Alumina THA

2007 ◽  
Vol 330-332 ◽  
pp. 1243-1246
Author(s):  
Jeong Joon Yoo ◽  
Hee Joong Kim ◽  
Young Min Kim ◽  
Kang Sup Yoon ◽  
Kyung Hoi Koo ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Polyethylene Wear ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Bearing Surface ◽  
The Mean ◽  
Acetabular Components ◽  
Cementless Acetabular Component ◽  
Acetabular Wall

Medial placement of a cementless acetabular component into or beyond the medial wall of a shallow, dysplastic acetabulum is a technique to enhance its coverage during difficult total hip arthroplasty (THA). Dysplastic hips almost always need small size of acetabular component, so an accelerated polyethylene wear can occur when a conventional bearing surface is used. Modern alumina-on-alumina couplings can be an alternative for these patients. We evaluated the clinical results of 43 medially placed cementless acetabular components (PLASMACUP®SC) incorporating a modern alumina bearing surface (BIOLOX® forte). Acetabular components were inserted medially beyond the ilioischial line and, therefore, beyond the level of the cortical bone of the cotyloid notch, and followed up for more than 5 years (range, 60 – 93 months). In 14 hips, the medial acetabular wall was perforated purposefully and the medial aspect of the cup was placed beyond both the ilioischial and the iliopubic line on radiographs. The mean Harris hip score improved from 55.3 points preoperatively to 94.5 points postoperatively. Postoperatively, the hip center migrated 12.1 mm medially and 1.5 mm inferiorly. The average amount of cup protrusion beyond the ilioischial and the iliopubic line was 3.1 mm and 1.9 mm, respectively. The average superolateral coverage of the cup was 98.5 percent. During follow-up, no osteolysis or loosening of acetabular components was observed and no revision was required. Medial placement of a cementless acetabular component into or beyond the medial acetabular wall offers predictable clinical results and durable fixation in modern alumina-on-alumina THA.

scholarly journals Association of Chronic Pain with Radiologic Severity and Central Sensitization in Hip Osteoarthritis Patients

2021 ◽  
Vol Volume 14 ◽  
pp. 1153-1160
Author(s):  
Takafumi Hattori ◽  
Kazuhiro Shimo ◽  
Yuto Niwa ◽  
Yuji Tokiwa ◽  
Takako Matsubara
Keyword(s):  
Chronic Pain ◽  
Central Sensitization ◽  
Hip Osteoarthritis

scholarly journals Central sensitization inventory scores correlate with pain at rest in patients with hip osteoarthritis: a retrospective study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshihisa Ohashi ◽  
Kensuke Fukushima ◽  
Gen Inoue ◽  
Kentaro Uchida ◽  
Tomohisa Koyama ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Central Sensitization ◽  
Hip Osteoarthritis ◽  
Central Sensitization Inventory ◽  
Pain At Rest

scholarly journals Sustained-release diclofenac conjugated to hyaluronate (diclofenac etalhyaluronate) for knee osteoarthritis: a randomized phase 2 study

Rheumatology ◽  
2020 ◽  
Author(s):  
Yoshihiro Nishida ◽  
Kazuyuki Kano ◽  
Yuji Nobuoka ◽  
Takayuki Seo
Keyword(s):  
Pain Score ◽  
Womac Pain ◽  
Walk Test ◽  
Phase 2 ◽  
Double Blind ◽  
Knee Oa ◽  
Phase 2 Study ◽  
The Mean ◽  
Secondary Outcomes ◽  
Daily Pain

Abstract Objective To evaluate the efficacy and safety of diclofenac etalhyaluronate (DF-HA) (ONO-5704/SI-613), a novel DF-conjugated hyaluronate, in patients with knee OA in Japan. Methods In this randomized, double-blind, placebo-controlled phase 2 study, patients were randomly assigned (1:1) to receive either 30 mg of DF-HA or placebo intra-articularly at weeks 0, 4 and 8 and were followed up for 24 weeks. The primary outcomes were changes from baseline in the WOMAC pain subscores, 50-foot walk test pain score and daily pain score. The secondary outcomes were the WOMAC physical function subscores, patient global assessment, responder rate and safety outcome. Results Overall, 176 patients received the investigational drugs (87 received DF-HA and 89 received placebo). The mean changes in the WOMAC pain subscores and daily pain score from baseline over 12 weeks after the first injection were significantly higher in the DF-HA than placebo group; the mean difference was −7.0 mm [95% CI, −12.7, −1.2; P =0.018] and −0.61 (95% CI, −1.06, −0.16; P =0.008), respectively. The difference in the 50-foot walk test pain score was −5.0 mm (95% CI, −10.3, 0.3; P =0.065). Improvement of pain by DF-HA was observed at week 1 and maintained from week 12 to week 24. Significantly greater improvements in the secondary outcomes were also observed with DF-HA than with placebo. No clinically significant adverse events occurred. Conclusion DF-HA reduced pain in patients with knee OA without major safety concerns. Trial registration UMIN Clinical Trials Registry, https://www.umin.ac.jp/ctr/index.htm, UMIN000015858

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