Mechanisms of Pain Sensitisation in Knee OA and Predicting Chronic Pain After TKR Surgery

Description

The video features Tom Kurien, an orthopedic consultant from Nottingham, who presents a detailed exploration of chronic pain following knee replacement surgeries. He discusses the rising global prevalence of knee replacements and highlights the significant incidence of chronic pain post-operation, ranging from 5% to 20% of patients. Kurien emphasizes the necessity for clinicians to identify preoperative risk factors for chronic pain development, including synovitis, genetics, and factors related to mental health like anxiety and depression.



The presentation delves into complex concepts such as central sensitization, where chronic pain signals in the body create widespread pain responses. He explains the neurophysiological mechanisms involved, illustrated using analogies like the oxygen dissociation curve to explain pain perception.



Kurien discusses research findings that associate preoperative pain catastrophizing with long-term chronic pain outcomes. Additionally, he introduces potential clinical assessment tools, including the pain detect questionnaire for identifying neuropathic pain components and the use of imaging studies to visualize pain pathways. He mentions the work on functional MRI scans in knee osteoarthritis patients and the correlation of synovitis with central sensitization, suggesting the S2 brain region as a potential biomarker.



Moreover, Kurien addresses innovative trials, including digital health therapies for managing knee osteoarthritis pain and an upcoming study linking exercise to gut microbiome changes for pain management. He concludes with a call for enhanced pain phenotyping procedures in clinical settings to better tailor treatments and expectations for patients undergoing knee surgeries.

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Conferences