Long-term pain after TKR (Beswick)

What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients.

Beswick AD, Wylde V, Gooberman-Hill R, et al. BMJ open 2012 · PMID 22357571 · doi:10.1136/bmjopen-2011-000435

Question

What proportion of patients have persistent pain after hip or knee replacement for osteoarthritis?

Design

Systematic review of prospective cohort studies in unselected patients.

Patients

Patients undergoing primary total hip or knee replacement for osteoarthritis.

Intervention

Total knee or hip replacement

Comparison

Not applicable

Primary outcome

Proportion reporting unfavourable long-term pain (3 months to 5 years)

Key result

Roughly 10-34% of patients after TKR reported unfavourable long-term pain, compared with about 7-23% after THR, a higher proportion after knee than hip replacement.

Limitations

Heterogeneous definitions of pain and follow-up times across included studies.

Impact on practice

Underpins the commonly quoted figure that around one in five patients report persistent pain after TKR, central to informed consent.