The Sphygmomanometer Pain Test: A Simple Method for Identifying Patients at Risk of Excessive Pain after Total knee Arthroplasty

J Arthroplasty. 2016 Apr;31(4):798-801. doi: 10.1016/j.arth.2015.10.027. Epub 2015 Oct 31.

Abstract

Background: Despite the overall success of total knee arthroplasty (TKA), a relatively large proportion of patients remain dissatisfied with the outcome. We hypothesized that patients with a lower threshold for pain were more likely to have worse outcomes after TKA.

Methods: Forty-eight consecutive patients with primary knee osteoarthritis graded a standardized painful stimulus caused by inflating a sphygmomanometer placed on the forearm, on a visual analog scale (VAS) scale before their TKA. We compared the VAS scores to patients' Knee Society scores and Knee Society function scores 2 years after TKA.

Results: Patients with a severe VAS score (>74 mm) had significantly worse Knee Society scores compared to patients with mild (0-44 mm) and moderate (45-74 mm) VAS scores (55 ± 20.5 vs 81.5 ± 11.1 and 84.8 ± 13, respectively, P = .04) and worse Knee Society Function scores (34 ± 20.7 vs 75.2 ± 17.3 and 77 ± 17.4, respectively, P = .027) at 2 years after TKA.

Conclusions: Patients with a lower threshold for pain, as determined by a standardized painful stimulus, are more likely to have lower Knee Society pain and function scores after TKA.

Keywords: catastrophizing pain; functional score; patient satisfaction; total knee arthroplasty; visual analog scale.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Female
  • Humans
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery
  • Pain / etiology
  • Pain Measurement / instrumentation
  • Pain Measurement / methods*
  • Pain, Postoperative / etiology*
  • Prospective Studies
  • Sphygmomanometers
  • Treatment Outcome