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      Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

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          Abstract

          A significant proportion of osteoarthritis (OA) patients continue to experience moderate to severe pain after total joint replacement (TJR). Preoperative factors related to pain persistence are mainly studied using individual predictor variables and distinct pain outcomes, thus leading to a lack of consensus regarding the influence of preoperative parameters on post-TJR pain. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models and network analysis were applied to pain related biopsychosocial measures and their changes with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Although distinct pain scales were associated with different aspects of post-surgical pain, multi-factorial models did not reliably predict post-surgical pain in knee OA (across four distinct pain scales) and did not generalize to hip OA. However, network analysis showed significant changes in biopsychosocial-defined OA personality post-surgery, in both groups. Our results show that although tested clinical and biopsychosocial variables reorganize after TJR in OA, their presurgical values are not predictive of post-surgery pain. Derivation of prognostic markers for pain persistence after TJR will require more comprehensive understanding of underlying mechanisms.

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          Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases.

          This paper reports the development of a self-report instrument designed to assess pain in cancer and other diseases. It is argued that issues of reliability and validity should be considered for every pain questionnaire. Most research on measures of pain examine reliability to the relative neglect of validity concerns. The Wisconsin Brief Pain Questionnaire (BPQ) is evaluated with regard to both reliability and validity. Data from patients with cancer at 4 primary sites and from patients with rheumatoid arthritis suggest that the BPQ is sufficiently reliable and valid for research purposes. Additional methodological and theoretical issues related to validity are discussed, and the need for continuing evaluation of the BPQ and other measures of clinical pain is stressed.
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            Validity of the Brief Pain Inventory for Use in Documenting the Outcomes of Patients With Noncancer Pain

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              Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis.

              Several studies have identified clinical, psychosocial, patient characteristic, and perioperative variables that are associated with persistent postsurgical pain; however, the relative effect of these variables has yet to be quantified. The aim of the study was to provide a systematic review and meta-analysis of predictor variables associated with persistent pain after total knee arthroplasty (TKA).
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Data curationRole: Resources
                Role: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                8 January 2020
                2020
                : 15
                : 1
                : e0222370
                Affiliations
                [1 ] Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde—i3S, Universidade do Porto, Porto, Portugal
                [2 ] Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America
                [3 ] Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America
                [4 ] Shirley Ryan AbilityLab, Chicago, IL, United States of America
                [5 ] Departamento de Medicina Física e de Reabilitação, Centro Hospitalar e Universitário de São João, Porto, Portugal
                [6 ] Department of Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America
                Monash University, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-7826-5354
                http://orcid.org/0000-0002-9788-7458
                Article
                PONE-D-19-23720
                10.1371/journal.pone.0222370
                6948829
                31914126
                025ed63c-187e-40f8-a5a6-2858293ce204

                This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

                History
                : 22 August 2019
                : 13 December 2019
                Page count
                Figures: 5, Tables: 4, Pages: 22
                Funding
                J.B. was funded through CCDRN [Norte-08-5369-FSE-000026], OARSI Collaborative Scholarship 2018 and Luso-American Development Foundation R&D@PhD scholarship grant. This research did not receive other specific funding from agencies in the public or commercial sectors.
                Categories
                Research Article
                Medicine and Health Sciences
                Rheumatology
                Arthritis
                Osteoarthritis
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Body Limbs
                Legs
                Knees
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Body Limbs
                Legs
                Knees
                Medicine and Health Sciences
                Diagnostic Medicine
                Signs and Symptoms
                Pain
                Neuropathic Pain
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Pain
                Neuropathic Pain
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Pelvis
                Hip
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Pelvis
                Hip
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Multivariate Analysis
                Principal Component Analysis
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Multivariate Analysis
                Principal Component Analysis
                Biology and Life Sciences
                Physiology
                Sensory Physiology
                Somatosensory System
                Pain Sensation
                Medicine and Health Sciences
                Physiology
                Sensory Physiology
                Somatosensory System
                Pain Sensation
                Biology and Life Sciences
                Neuroscience
                Sensory Systems
                Somatosensory System
                Pain Sensation
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Custom metadata
                All relevant data are within the manuscript.

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                Uncategorized

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