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Wang S, Yao S, Wei J, Shang L, Xu C, Ma J. Psychometric Properties of the Brief Pain Inventory Among Patients With Osteoarthritis Undergoing Total Knee Arthroplasty Surgery. J Arthroplasty 2024; 39:672-676. [PMID: 37648099 DOI: 10.1016/j.arth.2023.08.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/07/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is characterized by pain and functional restrictions, necessitating precise and reliable pain evaluation for effective disease surveillance and postoperative treatment appraisal. METHODS This investigation recruited 110 participants who were slated to receive unilateral total knee arthroplasty (TKA) and administered 3 self-reported questionnaires: the Brief Pain Inventory (BPI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 5-level EuroQoL Group's 5-dimension questionnaire (EQ-5D-5L), at baseline and 1 year after surgery. Using standard statistical methods and indicators, the BPI was subjected to a battery of psychometric evaluations, including assessments of reliability, validity, and responsiveness. RESULTS At baseline, there were no significant ceiling or floor effects observed. Additionally, the internal consistency reliability (Cronbach's alpha) of the BPI was above 0.8, suggesting that the questionnaire items are adequately related to one another. The study found moderate to very strong correlations between the pain and physical function domains of the BPI and Western Ontario and McMaster Universities Osteoarthritis Index, as well as a strong correlation between the functional interference dimension of the BPI and the EQ-5D, supporting the construct validity of the BPI. Also, the BPI was found to be responsive to changes in pain over time, with a responsiveness index ranging from 2.55 to 3.19. CONCLUSION The BPI assessment tool demonstrated good reliability, validity, and responsiveness in knee osteoarthritis patients who have undergone TKA and can be a useful measurement tool in clinical research to evaluate the effectiveness of pain management strategies and surgical interventions.
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Affiliation(s)
- Shunxing Wang
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China; Xi'an Medical University, Xi 'an, China
| | - Shuxin Yao
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Jie Wei
- State Key Laboratory of Cancer Biology, Department of Pathology, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | - Lei Shang
- Department of Health Statistics, Faculty of Preventive Medicine, the Air Force Military Medical University, Xi'an, China
| | - Chao Xu
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Jianbing Ma
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
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Colovic D, Draschl A, Reinbacher P, Hecker A, Schittek G, Fischerauer SF, Leithner A, Klim SM, Koutp A, Wittig U, Brunnader K, Sandner-Kiesling A, Sadoghi P. Evaluation of Neuropathic Pain after Total Knee Arthroplasty: Do Yellow Flags Matter? J Clin Med 2023; 12:7708. [PMID: 38137778 PMCID: PMC10743389 DOI: 10.3390/jcm12247708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Up to 20% of total knee arthroplasty (TKA) patients continue to experience chronic postsurgical pain. Various factors have been identified as potential contributors, including so-called "yellow flags", encompassing symptoms of depression, anxiety, and catastrophizing, which were examined in this study to assess their predictive value concerning functional outcomes after TKA. METHODS Fifty TKA patients were categorized into high-risk and low-risk groups based on clinical assessment, demographic data, medication, and patient-reported outcome measures (DN4, SF-36, WOMAC, NRS, Fibromyalgia Survey Questionnaire, Pain Catastrophizing Scale, and Hospital Anxiety and Depression Scale). Postoperative outcomes within six months after TKA were then compared. RESULTS Both groups exhibited significant (p < 0.001) improvements in all WOMAC and NRS subscales, as well as in the physical function, role physical, pain, and energy/fatigue subdomains of the SF-36 after six months, while the high-risk group showed lower WOMAC scores regarding stiffness (19.0 ± 18.3 vs. 27.2 ± 20.7, p < 0.001) and pain (13.5 ± 13.3 vs. 15.1 ± 16.3, p = 0.029). The high-risk group showed significantly worse preoperative DN4 scores (1.8 ± 1.3 vs. 3.0 ± 1.1, p = 0.002) than the low-risk group, which persisted for one day (2.3 ± 1.2 vs. 3.5 ± 1.5, p = 0.005) and six weeks (2.2 ± 1.9 vs. 3.6 ± 2.3, p = 0.041) postoperatively. CONCLUSIONS Our results indicate that pre-existing yellow flags contribute to a more challenging early postoperative phase, underscoring the importance of considering individual patient characteristics and psychological factors to optimize TKA outcomes.
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Affiliation(s)
- Danijel Colovic
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Alexander Draschl
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036 Graz, Austria
- COREMED—Centre for Regenerative Medicine and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, 8010 Graz, Austria
| | - Patrick Reinbacher
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036 Graz, Austria
- COREMED—Centre for Regenerative Medicine and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, 8010 Graz, Austria
| | - Gregor Schittek
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5/5, 8036 Graz, Austria;
| | - Stefan Franz Fischerauer
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Andreas Leithner
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Sebastian Martin Klim
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Amir Koutp
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Ulrike Wittig
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Kevin Brunnader
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Andreas Sandner-Kiesling
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5/5, 8036 Graz, Austria;
| | - Patrick Sadoghi
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
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