Social determinants associated to chronic pain after total knee arthroplasty

• Published in: International orthopaedics 2019-12, Vol.43 (12), p.2767-2771
• Main Authors: Núñez-Cortés, Rodrigo, Chamorro, Claudio, Ortega-Palavecinos, Maritza, Mattar, Gustavo, Paredes, Orlando, Besoaín-Saldaña, Álvaro, Cruz-Montecinos, Carlos
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Paper; Orthopedics
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-019-04370-6

Aim of the study Analyze the association between social health determinants (SHD) and chronic post-surgical pain (CPSP) after total knee arthroplasty (TKA). Method A cross-sectional study was performed in 58 TKA patients. The subjects were classified in two groups: with ( n  = 22) or without ( n  = 36) CPSP. SHD considered were gender, age, educational level, economic income, and labour conditions. Results Significant differences were found concerning educational level when comparing subjects with or without CPSP, with a low educational level of 22.4% and 19%, respectively. 15.5% of patients with persistent pain had a high educational level compared with 43.1% of the patients without persistent pain ( p  = 0.032). No significant differences were found for the other categories ( p  > 0.05). The odds ratio (95% confidence interval) was 3.28 (1.09–9.93) for lower educational level compared with high educational level. Discussion CPSP must be considered a severe health problem. In addition to SDH, there are multiple factors associated with chronic pain after TKA that must be considered for an effective treatment. Conclusions Patients with lower educational level showed a three-time higher association to develop CPSP. Considering SHD could be of relevance when elaborating new interventions or health strategies and more specialized counseling for patients with persistent pain after TKA.