L’algométrie par pression est un excellent outil de mesure de la douleur après ostéotomie titbiale de fermeture - 28/02/18

Pressure algometry is an excellent tool to measure knee pain relief after a closing-wedge high tibial osteotomy

Doi : 10.1016/j.rcot.2018.01.005

R. Torres-Claramunt ^a,^⁎,^b,^c , X. Pelfort ^b, P. Hinarejos ^a,^c, S. Gil-González ^b, J. Leal ^a, J.F. Sánchez-Soler ^a,^c, J.C. Monllau ^a,^c
^a Orthopaedic department, Parc de Salut Mar, Passeig Marítim, 25-29, Universitat Autònoma, 08009 Barcelona, Espagne
^b Consorci Sanitari de l’Anoia, Barcelona, Espagne
^c IMIM (Hospital del Mar Medical Research Institute), Barcelona, Espagne

^⁎Auteur correspondant.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 28 February 2018
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Purpose

The aim of this study was to assess the utility of pressure algometry (PA), to measure pain relief in the medial part of the knee after a closing-wedge high tibial osteotomy (CWHTO).

Methods

Prospective study including 44 CWHTO. Pain relief was evaluated with the visual analogue scale (VAS) and PA, a radiological study was done and a functional assessment was carried out with the KSS pre-operatively, at 6-months and at 1-year after the surgery. PA was applied to the medial and lateral part of the knee and to the infra-clavicular fossa as a control point.

Results

The mechanical femorotibial angle was changed from 172.2 (SD2.2) to 180.6 (SD2.6)(P=0.00). KSS Knee improved from 53.4 (SD11.2) to 92.8 (SD7.3)(P=0.00), KSS Function from 69.4(SD9.3) to 93.1 (SD8)(P=0.00). The VAS went from 6.84 (SD1.5) to 2.5 (SD2.1)(P=0.00) at the 1-year follow-up. The pressure pain threshold (PPT), measured with PA in the medial part of the knee also improved from 348.8kPa (SD159.3) to 447.1kPa (SD218.8)(P=0.01). However, the PPT in the lateral part of the knee and in the sub-clavicular fossa remained the same from the pre-operative period to 6-months and 1-year, postoperatively. Neither were there any differences between the 6-months and 1-year postoperative values in terms of the different functional, radiological and pain relief obtained.

Conclusion

The pain relief obtained after a CWHTO in the medial part of the knee can be measured by using PA. Furthermore, the functional and pain improvement obtained at 1-year follow-up is no better than those obtained at 6-months postoperatively.

Le texte complet de cet article est disponible en PDF.

Keywords : Algometry, Threshold, Pain, Osteotomy, Knee, Pressure

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.