Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study

Abstract

Purpose

The development of persistent postoperative pain may occur following surgery, including total hip replacement. Yet, the prevalence may depend on the definition of persistent pain. This observational cohort study explored whether the prevalence of persistent pain after total hip replacement differs depending on the definition of persistent pain and evaluated the impact of ongoing pain on the patient’s quality of life 6 months after surgery.

Patients and methods

Pre- and postoperative characteristics of 125 patients undergoing elective total hip replacement were assessed and 104 patients were available for the follow-up interview, 6 months after surgery.

Results

Six months after surgery, between 26% and 58% of patients still reported hip pain – depending on the definition of persistent pain. Patients with moderate-to-severe persistent pain intensity (>3 on a numerical rating scale) were more restricted in their daily life activities (Chronic Pain Grade – disability score) but did not differ in reported quality of life (Short-Form 12) from those with no pain or milder pain intensity. Maximal preoperative pain intensity and body mass index were the only independent factors influencing daily function 6 months after total hip replacement.

Conclusion

These findings support a high prevalence of persistent postoperative pain after total hip replacement and a large variability depending on the definition used. There was a close relation between physical functioning and pain as well as relevance of the patient’s psychological state at the time of the operation.

Keywords:

• chronic postoperative pain
• acute pain management
• hip replacement
• quality of life
• German Pain Questionnaire

Supplementary material

Table S1 Properties of variables and test

Acknowledgments

We would like to express our gratitude to Professor Dr. Henning Windhagen and his team at the Department of Orthopedic Surgery, Medical School Hannover, Germany, who supported the conduction of the study. We would also like to express our gratitude to our colleague Astrid Degenhart (A.D.) and our research assistants Merle Gathmann (M.G.) and Stephanie Biallas (St.B.).

Author contributions

All authors contributed toward data collection and interpretation, drafting and critically revising the paper, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.