SynthesisBMJ open2025
What proportion of people have long-term pain after total hip or knee replacement? An update of a systematic review and meta-analysis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Peripheral nerve blocks for total knee arthroplasty: a bibliometric and visual analysis, 2016-2025.Frontiers in medicine · 2026Pooled it
- The effects of supervised exercise and pain neuroscience education on muscle strength and power in patients with chronic pain after total knee arthroplasty: An exploratory analysis from the NEPNEP trial.Osteoarthritis and cartilage open · 2026Trial
- Impact of upper-limb aerobic exercise on the prevention of chronic postsurgical pain after total knee arthroplasty: a randomized controlled trial.BMC research notes · 2026Trial
- Cooled radiofrequency ablation for patients with chronic postsurgical pain after total knee arthroplasty: Pilot clinical trial.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2026Article
- Letter to the Editor: Analytic approaches for prognostic studies of persistent pain following knee arthroplasty.Acta orthopaedica · 2026Article
- Stakeholders' Perspectives on the Development of the Early Pain Intervention After Knee Replacement Model of Care: A Qualitative Study.ACR open rheumatology · 2026Article
- The potential of [European journal of nuclear medicine and molecular imaging · 2026Article
- Chronic Pain and Stiffness After Total Knee Arthroplasty: A Comprehensive, Phenotype-Based Review of Mechanisms, Diagnosis and Management.Journal of clinical medicine · 2026Review
- Repeated Genicular Artery Embolization Using Permanent Microspheres for Severe Osteoarthritis and Postsurgical Pain.Cardiovascular and interventional radiology · 2026Observational
- Acetabular cup anteversion measurement in total hip arthroplasty: reliability of metal artifact reduction MRI compared with CT.Skeletal radiology · 2026Article
- Effects of Mechano-Sonic Vibration Therapy on Muscle Strength, Pain, and Joint Function in Elderly Patients Undergoing Total Knee and Hip Arthroplasty: A Retrospective, Case-Control Study.Journal of personalized medicine · 2026Article
- Integrating a multidisciplinary pain management team and patient-reported outcomes into enhanced recovery after total knee arthroplasty.Journal of anesthesia · 2026Article
- High-impact chronic pain after total joint arthroplasty: a longitudinal cohort study.Pain reports · 2026Article
- Development of risk prediction model for chronic pain after knee replacement surgery: protocol for an individual patient data meta-analysis.Perioperative medicine (London, England) · 2026Article
- Article
- Biopsychosocial predictive factors for developing chronic postsurgical pain after hip replacement surgery: A systematic review.Osteoarthritis and cartilage open · 2026Review
- Genicular Artery Embolization Using Resorbable Gelatin Microspheres for Refractory Knee Pain: Technique, Safety and Clinical Outcome.Cardiovascular and interventional radiology · 2026Observational
- Article
- Association of a Physician-Nurse Collaborative Multimodal Analgesic Pathway with Early Pain Trajectories and Institution-Recorded Opioid Use After Total Knee Arthroplasty: A Propensity Score-Matched Retrospective Cohort Study.Journal of pain research · 2026Article
- Increasing Denials of Genicular Nerve Procedures Threaten Post-TKA Pain Management and May Drive Opioid Utilization.Orthopedic reviews · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo update our previous systematic review to synthesise latest data on the prevalence of long-term pain in patients who underwent total hip replacement (THR) or total knee replacement (TKR). We aim to describe the prevalence estimates and trends in this review.
designSystematic review and meta-analysis. DATA SOURCES: Update searches were conducted in MEDLINE and Embase databases from 1 January 2011 to 17 February 2024. Citation tracking was used to identify additional studies. ELIGIBILITY CRITERIA: We included prospective cohort studies reporting long-term pain after THR or TKR at 3, 6, 12 and 24 months postoperative. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently identified studies as eligible. One reviewer conducted data extraction, checked by a second reviewer. The risk of bias assessment was performed using Hoy's checklist. Bayesian, random-effects meta-analysis was used to synthesise the results.
resultsFor TKR, 68 studies with 89 time points, including 598 498 patients, were included. Multivariate meta-analysis showed a general decrease in pain proportions over time: 21.9% (95% CrI 15.6% to 29.4%) at 3 months, 14.1% (10.9% to 17.9%) at 6 months, 12.6% (9.9% to 15.9%) at 12 months and 14.6% (9.5% to 22.4%) at 24 months. Considerable heterogeneity, unrelated to examined moderators, was indicated by substantial prediction intervals in the univariate models. Substantial loss to follow-up and risk of bias led to low confidence in the results. For THR, only 11 studies were included, so it was not possible to describe the trend. Univariate meta-analysis estimated 13.8% (8.5% to 20.1%) and 13.7% (4.8% to 31.0%) of patients experiencing long-term pain 6 and 12 months after THR, respectively, though concerns in risk of bias results reduced confidence in these findings.
conclusionsOur review suggests that approximately 22% of patients report pain 3 months post-TKR, with 12%-15% experiencing long-term pain up to 2 years. At least 14% report pain 6-12 months after THR. Given the prevalence of chronic postsurgical pain, implementing existing and developing new preventive and management strategies is crucial for optimal patient outcomes. PROSPERO REGISTRATION NUMBER: CRD42023475498.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.