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Knee. 2013 Oct;20(5):316-8. doi: 10.1016/j.knee.2012.10.015. Epub 2012 Nov 14.

Inflammatory predictors of ongoing pain 2 years following knee replacement surgery.

Author information

1
Division of Orthopaedic Surgery, University Health Network, University of Toronto, Toronto ON, Canada. Rajiv.gandhi@uhn.on.ca

Abstract

INTRODUCTION:

The prevalence of unrelieved pain following total knee arthroplasty (TKA) is substantial.

OBJECTIVE:

We asked if cytokine markers of inflammation in preoperative serum or knee synovial fluid (SF) would predict pain 2 years following TKA.

METHODS:

Demographic data and functional outcomes were recorded at baseline and 2 years with the WOMAC index. Serum and SF tissue samples were collected at the time of surgery. Linear regression modeling was used to determine the relationship between SF/serum inflammatory markers and a lesser improvement in self reported pain at two years follow-up.

RESULTS:

Of our 28 patient cohort, significant correlations between serum and SF levels were found for IL-1β (p<0.002), MIP-1β (p<0.001), adiponectin (p<0.001) and leptin (p<0.001). Adjusted analysis showed that greater SF concentrations of TNF-α, MMP-13 and IL-6 were independent predictors of less pain improvement at two years follow-up (p<0.05).

CONCLUSIONS:

Those patients, having ongoing pain despite no clinical or radiological cause, may have an inflammatory profile characterizing a predisposition to ongoing pain after TKA.

LEVEL OF EVIDENCE:

Prognosis study, Level 2.

KEYWORDS:

Cytokines; Inflammation; Knee arthroplasty; Pain

PMID:
23157967
DOI:
10.1016/j.knee.2012.10.015
[Indexed for MEDLINE]
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