Preoperative angiotensin II type 2 receptor is a predictor for developing chronic post-surgical pain after total knee arthroplasty surgery

This study aimed to explore whether preoperative angiotensin II type 2 receptor (AT2R) level in knee osteoarthritis (OA) patients was an independent risk factor for chronic post-surgical pain (CPSP) after total knee arthroplasty (TKA). A total of 220 patients who had undergone unilateral TKA were en...

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Bibliographic Details
Published in:Life sciences (1973) 2021-08, Vol.278, p.119654-119654, Article 119654
Main Authors: Chen, Fan, Gao, Wei, Hu, Jicheng, Yang, Xinlu, Chai, Xiaoqing, Wang, Di
Format: Article
Language:English
Subjects:
Angiotensin
Angiotensin II
Angiotensin II type 2 receptor
Arthritis
Arthroplasty (knee)
Biomedical materials
Chronic post-surgical pain
Joint replacement surgery
Joint surgery
Knee
Neuropathic pain
Orthopaedic implants
Osteoarthritis
Pain
Patients
Phenotyping
Receptors
Regression analysis
Risk analysis
Risk factors
Sensory testing
Surgery
Total knee arthroplasty
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Summary:This study aimed to explore whether preoperative angiotensin II type 2 receptor (AT2R) level in knee osteoarthritis (OA) patients was an independent risk factor for chronic post-surgical pain (CPSP) after total knee arthroplasty (TKA). A total of 220 patients who had undergone unilateral TKA were enrolled from October 2019 to January 2020. Quantitative sensory testing (QST), PainDETECT questionnaires (PD-Q), the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), the hospital anxiety and depression (HAD) and serum AT2R were collected preoperatively. The primary outcome was the incidence of CPSP, which was defined as the visual analogue scale (VAS) score ≥ 4 in the ipsilateral knee joint six months after operation. The prevalence of CPSP was 13.6% (n = 30). Multiple logistic regression analysis showed that patients with higher AT2R level (OR: 1.007, 95% CI: 1.003–1.011) and PD-Q score (OR: 1.146, 95% CI: 1.008–1.298) before surgery had an increased risk of CPSP after surgery, and a combination of preoperative AT2R and PD-Q (Akaike information criterion: 147.2; area under receiver operating characteristic (ROC) curve: 0.890) was able to correctly classify 90.16% of patients into CPSP positive or negative groups. Our findings suggest that patients with higher preoperative AT2R level are at increased risk of developing CPSP following TKA. AT2R may serve as a candidate predictor for phenotyping CPSP in OA patients.
ISSN:0024-3205
1879-0631
DOI:10.1016/j.lfs.2021.119654