PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty
Objective: To investigate whether neuropathic-like pain, identified using the PainDETECT questionnaire, predicts postoperative symptoms, using data from 2 independent, prospective cohort studies. Patients and Methods: Data were collected from patients undergoing primary knee arthroplasty for primary...
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Elsevier
2025-10-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454825000608 |
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| author | Amanda J.W. Wall, MSc Kirsten M. Leyland, MSc, DPhil Amit Kiran, PhD Nigel K. Arden, MD Cyrus Cooper, MA, DM Vishvarani Wanigasekera, MBBS, DPhil M. Kassim Javaid, MBBS, PhD Andrew J. Price, MA, PhD Irene M.C. Tracey, MA, DPhil Anushka Irani, MA, BM BCh, DPhil |
| author_facet | Amanda J.W. Wall, MSc Kirsten M. Leyland, MSc, DPhil Amit Kiran, PhD Nigel K. Arden, MD Cyrus Cooper, MA, DM Vishvarani Wanigasekera, MBBS, DPhil M. Kassim Javaid, MBBS, PhD Andrew J. Price, MA, PhD Irene M.C. Tracey, MA, DPhil Anushka Irani, MA, BM BCh, DPhil |
| author_sort | Amanda J.W. Wall, MSc |
| collection | DOAJ |
| description | Objective: To investigate whether neuropathic-like pain, identified using the PainDETECT questionnaire, predicts postoperative symptoms, using data from 2 independent, prospective cohort studies. Patients and Methods: Data were collected from patients undergoing primary knee arthroplasty for primary osteoarthritis recruited to the Evaluation of perioperative Pain in Osteoarthritis of the kNEe (EPIONE) Study n=120, from October 1, 2011, to May 30, 2014, and the Clinical Outcomes in Arthroplasty Study (COASt) n=404, from January 1, 2010, to December 31, 2018). The PainDETECT questionnaire score was used to divide patients into nociceptive (<13), unclear (13-18), and neuropathic pain (>18) groups preoperatively using validated cutoffs. As the neuropathic group also captures nociplastic pain, we used neuropathic-like to represent this combination. Surgical outcome was compared between groups using the Oxford Knee Score (OKS) and the presence of moderate to severe pain 12 months after arthroplasty. Results: Total of 296 (56%) reported nociceptive, 144 (27%) unclear, and 84 (16%) neuropathic-like pain preoperatively. Patients in the neuropathic-like pain group had significantly worse OKS postoperatively, compared with the nociceptive group (34 [12] vs 40 [8], P<.05), independent of baseline OKS, age, sex, and body mass index. Moderate to severe pain 12 months after arthroplasty was statistically significantly higher in the unclear (OR 2.19 [95% CI, 1.36-3.53]) and neuropathic-like (OR, 2.83 [95% CI, 1.58-5.09]) pain groups when compared with the nociceptive group. Conclusion: Patients classified presurgery as having unclear and neuropathic pain by the modified PainDETECT have considerably worse outcomes after surgery. Neuropathic pain categorized by this tool commonly has centralized pain features and is a potential predictor of ongoing postsurgical pain. Knowledge of this may aid informed decision-making with respect to surgical intervention for those with knee osteoarthritis. |
| format | Article |
| id | doaj-art-010ab861f1be40cab7c4af575c3151e1 |
| institution | Kabale University |
| issn | 2542-4548 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
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| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj-art-010ab861f1be40cab7c4af575c3151e12025-08-20T03:59:22ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482025-10-019510064910.1016/j.mayocpiqo.2025.100649PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee ArthroplastyAmanda J.W. Wall, MSc0Kirsten M. Leyland, MSc, DPhil1Amit Kiran, PhD2Nigel K. Arden, MD3Cyrus Cooper, MA, DM4Vishvarani Wanigasekera, MBBS, DPhil5M. Kassim Javaid, MBBS, PhD6Andrew J. Price, MA, PhD7Irene M.C. Tracey, MA, DPhil8Anushka Irani, MA, BM BCh, DPhil9Oxford University Centre for Integrative Neuroimaging, Nuffield Department Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UKArthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UKOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UKOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UKOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, UKOxford University Centre for Integrative Neuroimaging, Nuffield Department Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UKOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UKOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UKOxford University Centre for Integrative Neuroimaging, Nuffield Department Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UKOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK; Oxford University Centre for Integrative Neuroimaging, Nuffield Department Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK; Department of Rheumatology, Mayo Clinic, Jacksonville, FL; Correspondence: Address to Anushka Irani, MA, BM BCh, D.Phil, Department of Rheumatology, Mayo Clinic, 4500 San Pablo Rd S. Jacksonville, FL 32224.Objective: To investigate whether neuropathic-like pain, identified using the PainDETECT questionnaire, predicts postoperative symptoms, using data from 2 independent, prospective cohort studies. Patients and Methods: Data were collected from patients undergoing primary knee arthroplasty for primary osteoarthritis recruited to the Evaluation of perioperative Pain in Osteoarthritis of the kNEe (EPIONE) Study n=120, from October 1, 2011, to May 30, 2014, and the Clinical Outcomes in Arthroplasty Study (COASt) n=404, from January 1, 2010, to December 31, 2018). The PainDETECT questionnaire score was used to divide patients into nociceptive (<13), unclear (13-18), and neuropathic pain (>18) groups preoperatively using validated cutoffs. As the neuropathic group also captures nociplastic pain, we used neuropathic-like to represent this combination. Surgical outcome was compared between groups using the Oxford Knee Score (OKS) and the presence of moderate to severe pain 12 months after arthroplasty. Results: Total of 296 (56%) reported nociceptive, 144 (27%) unclear, and 84 (16%) neuropathic-like pain preoperatively. Patients in the neuropathic-like pain group had significantly worse OKS postoperatively, compared with the nociceptive group (34 [12] vs 40 [8], P<.05), independent of baseline OKS, age, sex, and body mass index. Moderate to severe pain 12 months after arthroplasty was statistically significantly higher in the unclear (OR 2.19 [95% CI, 1.36-3.53]) and neuropathic-like (OR, 2.83 [95% CI, 1.58-5.09]) pain groups when compared with the nociceptive group. Conclusion: Patients classified presurgery as having unclear and neuropathic pain by the modified PainDETECT have considerably worse outcomes after surgery. Neuropathic pain categorized by this tool commonly has centralized pain features and is a potential predictor of ongoing postsurgical pain. Knowledge of this may aid informed decision-making with respect to surgical intervention for those with knee osteoarthritis.http://www.sciencedirect.com/science/article/pii/S2542454825000608 |
| spellingShingle | Amanda J.W. Wall, MSc Kirsten M. Leyland, MSc, DPhil Amit Kiran, PhD Nigel K. Arden, MD Cyrus Cooper, MA, DM Vishvarani Wanigasekera, MBBS, DPhil M. Kassim Javaid, MBBS, PhD Andrew J. Price, MA, PhD Irene M.C. Tracey, MA, DPhil Anushka Irani, MA, BM BCh, DPhil PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty |
| title_full | PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty |
| title_fullStr | PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty |
| title_full_unstemmed | PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty |
| title_short | PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty |
| title_sort | paindetect as a potential tool for personalized medicine predicting outcome one year after knee arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2542454825000608 |
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