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Postoperative Painful Chronicization After Knee Replacement Surgery : Exploratory Study of BDNF's Kinetics

Not Applicable
Completed
Conditions
Total Knee Arthroplasty
Chronic Postoperative Pain
Interventions
Diagnostic Test: blood test
Registration Number
NCT04604847
Lead Sponsor
University Hospital, Montpellier
Brief Summary

Chronic pain is an extremely disabling disease. It is a major public health problem due to the lack of effective therapy.

Chronic postoperative pain (CPOP) is defined by a painful symptomatology in the operated area unrelated to previous pain, present for more than 3 months, and without any link to surgical complication.

The prevalence of chronicization of postoperative pain is 30% after total knee arthroplasty.

Identification of clinical, biological and psychological profiles are crucial to prevent CPOP.

A biologic factor, Brain Derived Neurotrophic Factor (BDNF) produced by a variety of cells is a key regulator of neuroplasticity. BDNF is increasingly studied in the mechanisms of cerebral sensitization and pain chronicization. The role of BDNF in pain of patients remains to be explored in a prospective study. The aim of this observational study is to compare the kinetics of BDNF after total knee arthroplasty in patients with and without CPOP.

Patients will be included in the study at the preanesthetic consultation. Serum BDNF levels will be measured preoperatively, 48h postoperatively, 3 and 6 months after surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Social security affiliation
  • Adult patients
  • Signed informed consent
  • Score ASA (American Society of Anesthesiology) 1-3
  • Total knee arthroplasty
Exclusion Criteria
  • Patient unable to exercise consent
  • Pregnant women
  • Vulnerable people
  • Patients not included in the postoperative rehabilitation program
  • Patients unable to complete the pain assessment questionnaires
  • Chronic pain patients (other than knee arthrosis)
  • Neuropathic pain patients (beforehand)
  • Inflammatory diseases, progressive cancer, sepsis, immunosuppression known

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Total knee arthroplastyblood testpatient operated for a total knee arthroplasty
Primary Outcome Measures
NameTimeMethod
BDNF levelpreoperative to 6 months after surgery

assessed by ELISA technique

Secondary Outcome Measures
NameTimeMethod
Anxiety and Depressionpreoperative to 6 months after surgery

evaluated by the Hospital Anxiety and Depression scale (HAD)

Pain levelpreoperative to 6 months after surgery

evaluated by Visual Analog Scale (VAS)

Neuropathic pain diagnosticpreoperative to 6 months after surgery

evaluated by neuropathic pain diagnostic questionnaire (DN4)

Postoperative rehabilitationpreoperative to 6 months after surgery

evaluated by the Brief Pain Questionary (BPI)

Health related quality of lifepreoperative to 6 months after surgery

evaluated by the SF-12 Health Survey

Pain level perceptionpreoperative to 6 months after surgery

evaluated by the The pain Catastrophizing Scale

Assessment of functional capacities in knee arthritispreoperative to 6 months after surgery

evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC)

Oxidative stress markerpreoperative to 6 months after surgery

8-iso-prostaglandin F2α level by biochemical labeling

Trial Locations

Locations (1)

Department of Anesthesiology and critical care, Lapeyronie University Hospital

🇫🇷

Montpellier, France

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