Project aims to reduce chronic pain after total joint replacement
Press release issued: 26 January 2007
New research led by the University of Bristol and North Bristol NHS Trust aims to improve patient’s outcomes after a total joint replacement such as a knee or hip replacement.
Most people experience a good and relatively pain-free outcome following the operation but some, around 15 to 30 per cent, experience severe and chronic pain – some of which is due to the implant but some remains medically unexplained.
The research project will ultimately set up a pre-operative screening programme that will identify the sorts of patients who are at risk of a poor outcome. To do this the researchers need to find which factors are predictive of developing chronic pain after total joint replacement.
Vikki Wylde, a University of Bristol researcher and postgraduate student is leading the project at Southmead Hospital under the guidance of orthopaedic consultants from North Bristol NHS Trust and professors at the University of Bristol and University of the West of England.
She said: “To get this research off the ground we are in the process of recruiting 220 patients who will undergo an extensive assessment both before their operation and then a year after surgery.
“Their X-rays will be graded and their psychological status assessed to find out if they are suffering from depression or anxiety, for example.
“We will also be using Quantitative Sensory Testing, know as QST, to measure pain thresholds and detect any changes to the central nervous system.
“Once this process has been completed we can begin to get a better idea about what sorts of patients are likely to experience chronic pain after knee replacement, and work with them before their operations to try and stop the pain from taking hold.”
Professor Ian Learmonth, Head of Orthopaedic Surgery, said: “Persistent unexplained pain is commonly encountered in a technically perfect total joint replacement and represents a huge disappointment to both the patient and the surgeon.
“The ability to identify those at risk and thus improve their outcomes will be of great benefit to susceptible patients”.