Chronic Postsurgical Pain after Primary Total Hip Arthroplasty for Osteoarthritis: A Nationwide Cross-Sectional Survey Study.

Abstract

Total hip arthroplasty (THA) is frequently performed in patients who have osteoarthritis to relieve pain and improve quality of life. However, there is limited contemporary data on satisfaction and risk of persistent postsurgical pain, even though it is essential for informed decision-making. The objective of our study was to investigate the incidence of chronic postsurgical pain, pain characteristics, use of analgesics, patient satisfaction, and willingness to undergo surgery again one year after THA for osteoarthritis. We conducted a nationwide cross-sectional online survey of unselected patients who underwent primary, unilateral THA for primary osteoarthritis. At one year after surgery, we invited 2,533 patients identified from two national registers to participate in the survey. The primary outcome was moderate to severe chronic postsurgical pain, defined as a numerical rating scale (NRS) score ≥ 4. The secondary outcomes included frequency of pain, pain interference with everyday life, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain domain, the Doleur Neuropatique 4 interview (DN4i), use of analgesics, satisfaction, and willingness to undergo surgery again. Of 1,880 (74.2%) respondents, 244 (13.0%) had moderate or severe chronic postsurgical pain (NRS ≥ 4), 1,715 (91.2%) patients were either satisfied or very satisfied with the result of surgery, and 1,752 (93.2%) would still have undergone surgery if they could go back in time. At one year after primary THA, at least 13% of Danish patients experienced moderate to severe postsurgical pain. However, up to 91% of patients reported being satisfied or very satisfied with the outcome.