Análisis causal del dolor postartroplastiapropuesta de un algoritmo diagnóstico-terapéutico

Abstract

Objective: The aim of this study was to determine the incidence of painful knee arthroplasty and performance a causal analysis of painful arthroplastyin our center. Material and Methods: A prospective observational study in which 540 patients undergoing primary cemented arthroplasty for two years.Were selected those suffering intense pain postarthroplasty. All patients were subjected to various tests in order to determine the most likely cause of pain. Similarly, for each patient a specific surgical treatment intended to address the cause of pain was realized. Results: Of the 541 primary arthroplasties performed, 63 patients suffered severe pain. The cumulative incidence of severe pain postartroplastia in our center during the two years of follow-up was 11.64 %. Mechanical causes were the most frequent justifying 52.4% of the cases, followed by intraarticular biological causes which constituted 34.9%. In 11.1% of cases could not determine any specific cause of painful arthroplasty considering therefore an unknown pain. Finally, extra-articular causes, which constituted only 1.6% of painful arthroplasty. Conclusions: The painful arthroplasty is a common complication of knee arthroplasty can have one in ten patients undergoing joint replacement surgery. The prosthetic pain has a multifactorial etiology, so the causal diagnosis is dificult and tedious. Certain factors, such as having psychiatric disorders , obesity , high demand and analgesic before surgery are associated with a greater likelihood of painful arthroplasty.