Capsular neuronal elements and their relation to pain reduction and functional improvement following total hip replacement

Abstract

We studied changes of pain intensity and functional impairment in 22 patients with osteoarthrosis undergoing total hip replacement. Using a visual analogue scale, the mean scores for pain and disability before surgery were 71.7 and 70.9 respectively. Both scores showed gradual improvement during a 1-year follow-up period, with more than 90% of the total improvement occurring within the first 3 months. After 1 year, the scores for pain and disability were 11.9 and 4.1 respectively. The hip joint capsule was studied using immunohistochemistry to detect neurofilaments. Neurofilament immunoreactivity was observed in 16/22 cases and was correlated with pain and disability scores. However, there were no correlations between pre- and postoperative pain scores, the score changes, and the quantity of capsular neurofilaments. Thus, other factors than capsular neurofilaments influence the scores of pain and disability in osteoarthritis.

Résumé

Nous avons étudié les changements d’intensité de la douleur et les modifications fonctionnelles chez 22 malades ayant subit une prothèse totale de la hanche pour arthrose. Avec une échelle analogue visuelle, les scores moyens pour la douleur et l’invalidité avant la chirurgie étaient de 71.7 et 70.9 respectivement. Les deux scores ont montré l’amélioration graduelle pendant une année après l’opération, avec plus de 90% de l’amélioration totale dans les trois premiers mois. Après une année les scores pour douleur et invalidité étaient de 11.9 et 4.1 respectivement. La capsule articulaire a été étudiée par immunohistochimie pour détecter les neurofilaments. L’immunoréactivité des neurofilaments a été observé dans 16/22 cas et était corrèlée avec la douleur et le score de l’invalidité. Cependant, il n’y avait pas de corrélations entre les scores de la douleur pré- et postopératoire, la modification du score fonctionnel et la quantité de neurofilaments capsulaires. Il y a donc d’autres facteurs que les neurofilaments capsulaires qui influencent la douleur et l’invalidité dans l’arthrose.

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Acknowledgements

This study was supported by a grant from the Hungarian Medical Research Council (60/2000). We express special thanks to Katalin Hodosi, Béláné Szanitter Magdolna Hajdú and László Kiss for their kind assistance.

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Correspondence to Levente Gáspár.

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Gáspár, L., Dezső, B., Csernátony, Z. et al. Capsular neuronal elements and their relation to pain reduction and functional improvement following total hip replacement. International Orthopaedics (SICOT) 28, 142–145 (2004). https://doi.org/10.1007/s00264-004-0539-0

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Keywords

  • Mast Cell
  • Visual Analogue Scale Score
  • Joint Capsule
  • Loose Connective Tissue
  • Neuronal Element