Kate N Jochimsen, Emilie Kramer, Joshua Van Wyngaarden, Brian Noehren, Michael A Samaan, Stephen T Duncan, Carl G Mattacola, Cale A Jacobs
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Therefore, we aimed to 1) identify the prevalence of temporal summation in patients undergoing hip arthroscopy for FAIS, 2) determine if there a difference in postoperative improvement between individuals with and without preoperative temporal summation, and 3) examine preoperative predictors of poor postoperative recovery.</p><p><strong>Methods: </strong>51 participants undergoing hip arthroscopy for FAIS underwent preoperative temporal summation testing. Three months postoperatively, 38 participants completed the 12-item International Hip Outcome Tool (iHOT-12) and reported their overall symptomatic improvement (0% to 100%, with 100% being normal). Participants were categorized on the presence ( Numeric Pain Rating Scale; NPRS 2) or absence ( NPRS < 2) of temporal summation. A Mann-Whitney U test was used to determine the difference in improvement between groups (temporal summation: temporal summation (TS), no temporal summation (NTS), and a linear regression was used to explore predictors of improvement.</p><p><strong>Results: </strong>23 (45.1%) of 51 participants displayed preoperative temporal summation. In participants with postoperative data, those with temporal summation reported less improvement than those without (TS: 62.8% 29.7%; NTS: 82.7% 13.9%; p = 0.01; Cohen's d = -0.86). Temporal summation (Beta = -0.48; 95% CI -36.6, -8.7) and mental health disorder (Beta = -0.30; 95% CI -28.0, -0.48) predicted 28.1% of the variance in postoperative improvement (p = 0.002).</p><p><strong>Conclusion: </strong>The presence of preoperative temporal summation is common and related to worse postoperative recovery after hip arthroscopy for FAIS.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 8","pages":"580-586"},"PeriodicalIF":1.2000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11353151/pdf/","citationCount":"0","resultStr":"{\"title\":\"Preoperative Temporal Summation is Associated with Impaired Recovery Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome .\",\"authors\":\"Kate N Jochimsen, Emilie Kramer, Joshua Van Wyngaarden, Brian Noehren, Michael A Samaan, Stephen T Duncan, Carl G Mattacola, Cale A Jacobs\",\"doi\":\"10.22038/ABJS.2024.78368.3607\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Chronic pain is a risk factor for worse outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Pain sensitization involves the central nervous system perceiving previously innocuous stimuli as noxious. Temporal summation can provide a surrogate measure of sensitization, and may be a clinical tool to identify patients at a higher risk for poor post-hip arthroscopy outcomes. Therefore, we aimed to 1) identify the prevalence of temporal summation in patients undergoing hip arthroscopy for FAIS, 2) determine if there a difference in postoperative improvement between individuals with and without preoperative temporal summation, and 3) examine preoperative predictors of poor postoperative recovery.</p><p><strong>Methods: </strong>51 participants undergoing hip arthroscopy for FAIS underwent preoperative temporal summation testing. Three months postoperatively, 38 participants completed the 12-item International Hip Outcome Tool (iHOT-12) and reported their overall symptomatic improvement (0% to 100%, with 100% being normal). Participants were categorized on the presence ( Numeric Pain Rating Scale; NPRS 2) or absence ( NPRS < 2) of temporal summation. A Mann-Whitney U test was used to determine the difference in improvement between groups (temporal summation: temporal summation (TS), no temporal summation (NTS), and a linear regression was used to explore predictors of improvement.</p><p><strong>Results: </strong>23 (45.1%) of 51 participants displayed preoperative temporal summation. In participants with postoperative data, those with temporal summation reported less improvement than those without (TS: 62.8% 29.7%; NTS: 82.7% 13.9%; p = 0.01; Cohen's d = -0.86). Temporal summation (Beta = -0.48; 95% CI -36.6, -8.7) and mental health disorder (Beta = -0.30; 95% CI -28.0, -0.48) predicted 28.1% of the variance in postoperative improvement (p = 0.002).</p><p><strong>Conclusion: </strong>The presence of preoperative temporal summation is common and related to worse postoperative recovery after hip arthroscopy for FAIS.</p>\",\"PeriodicalId\":46704,\"journal\":{\"name\":\"Archives of Bone and Joint Surgery-ABJS\",\"volume\":\"12 8\",\"pages\":\"580-586\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11353151/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Bone and Joint Surgery-ABJS\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22038/ABJS.2024.78368.3607\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Bone and Joint Surgery-ABJS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22038/ABJS.2024.78368.3607","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：慢性疼痛是股骨髋臼撞击综合征（FAIS）髋关节镜手术后恶化疗效的一个风险因素。痛觉过敏是指中枢神经系统将以前无害的刺激感知为有害刺激。时间总和可作为敏感性的替代测量指标，并可作为一种临床工具来识别髋关节镜术后预后不良风险较高的患者。因此，我们的目的是：1）确定因髋关节置换术后并发症而接受髋关节镜手术的患者中颞叶总和的发生率；2）确定术前有颞叶总和和没有颞叶总和的患者在术后改善方面是否存在差异；3）检查术前预测术后恢复不良的因素。术后三个月，38名受试者完成了由12个项目组成的国际髋关节结果工具（iHOT-12），并报告了他们的总体症状改善情况（0%至100%，100%为正常）。参与者根据是否存在（数字疼痛分级量表；NPRS 2）或不存在（NPRS < 2）时相加进行分类。曼-惠特尼 U 检验用于确定各组（颞叶总和：颞叶总和 (TS)、无颞叶总和 (NTS)）之间的改善差异，线性回归用于探索改善的预测因素。在有术后数据的参与者中，有时间相加现象者的病情改善程度低于无时间相加现象者（TS：62.8% 29.7%；NTS：82.7% 13.9%；P = 0.01；Cohen's d = -0.86）。颞叶总和（Beta = -0.48；95% CI -36.6，-8.7）和心理健康障碍（Beta = -0.30；95% CI -28.0，-0.48）预测了术后改善差异的 28.1%（P = 0.002）：结论：髋关节镜手术治疗FAIS后，术前颞叶总和的存在很常见，且与术后恢复较差有关。
Preoperative Temporal Summation is Associated with Impaired Recovery Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome .
Objectives: Chronic pain is a risk factor for worse outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Pain sensitization involves the central nervous system perceiving previously innocuous stimuli as noxious. Temporal summation can provide a surrogate measure of sensitization, and may be a clinical tool to identify patients at a higher risk for poor post-hip arthroscopy outcomes. Therefore, we aimed to 1) identify the prevalence of temporal summation in patients undergoing hip arthroscopy for FAIS, 2) determine if there a difference in postoperative improvement between individuals with and without preoperative temporal summation, and 3) examine preoperative predictors of poor postoperative recovery.
Methods: 51 participants undergoing hip arthroscopy for FAIS underwent preoperative temporal summation testing. Three months postoperatively, 38 participants completed the 12-item International Hip Outcome Tool (iHOT-12) and reported their overall symptomatic improvement (0% to 100%, with 100% being normal). Participants were categorized on the presence ( Numeric Pain Rating Scale; NPRS 2) or absence ( NPRS < 2) of temporal summation. A Mann-Whitney U test was used to determine the difference in improvement between groups (temporal summation: temporal summation (TS), no temporal summation (NTS), and a linear regression was used to explore predictors of improvement.
Results: 23 (45.1%) of 51 participants displayed preoperative temporal summation. In participants with postoperative data, those with temporal summation reported less improvement than those without (TS: 62.8% 29.7%; NTS: 82.7% 13.9%; p = 0.01; Cohen's d = -0.86). Temporal summation (Beta = -0.48; 95% CI -36.6, -8.7) and mental health disorder (Beta = -0.30; 95% CI -28.0, -0.48) predicted 28.1% of the variance in postoperative improvement (p = 0.002).
Conclusion: The presence of preoperative temporal summation is common and related to worse postoperative recovery after hip arthroscopy for FAIS.
期刊介绍：
The Archives of Bone and Joint Surgery (ABJS) aims to encourage a better understanding of all aspects of Orthopedic Sciences. The journal accepts scientific papers including original research, review article, short communication, case report, and letter to the editor in all fields of bone, joint, musculoskeletal surgery and related researches. The Archives of Bone and Joint Surgery (ABJS) will publish papers in all aspects of today`s modern orthopedic sciences including: Arthroscopy, Arthroplasty, Sport Medicine, Reconstruction, Hand and Upper Extremity, Pediatric Orthopedics, Spine, Trauma, Foot and Ankle, Tumor, Joint Rheumatic Disease, Skeletal Imaging, Orthopedic Physical Therapy, Rehabilitation, Orthopedic Basic Sciences (Biomechanics, Biotechnology, Biomaterial..).
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