Abstract
Patients overestimate pain following hip and knee replacement.
Ninety two patients awaiting hip or knee replacement were asked at their pre-operative assessment to estimate the level of pain they expected following their surgery on a 10cm visual analogue scale. Note was made of their age, gender, previous surgeries, Amsterdam anxiety score as regards the anaesthetic and surgery and an information score relating to their anaesthetic and surgery. Seventy nine patients had pain scores collected on a daily basis post surgery.
Mean (std dev) age of the group was 68 (11) years and with a female to male ratio of 1.57. Females were significantly more anxious about the surgery than males (t-test, p< 0.007). Patients were more anxious about the anaesthetic and the surgery with hip replacement compared to knee replacement although this did not reach significance (t-test p=0.07). The mean (std dev) pain score pre-operatively was 7.5 (1.6). The mean (std dev) pain score expected was 7.0 (2.2) on the first post operative day and 4.3 (2.2) on the sixth post operative day. Forty four per cent of patients expected to have pain greater than their arthritis pain on the day following surgery.
The level of pain experienced post-operatively was significantly lower than expected. Mean (std dev) pain score was 5.1 (2.7) on day 1 post op and 3.3 (2.4) on day 6 (t-test, p< 0.05 for both). There was no correlation between age, gender, number of previous surgeries, anxiety or information scores and the expected level of pain.
The majority of patients, whatever their age, gender or level of anxiety over estimate their level of post-operative pain after joint replacement. Studies are needed to assess whether educating patients about pain post surgery will be of benefit, particularly in their early rehabilitation.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
