Osteoarthritis (OA) of the knee is a common type of arthritis in Northern Ireland. A debilitating condition, sufferers report locking, grinding and instability of the knee, with severe difficulties in walking, standing, domestic and occupational activities. While conservative management is appropriate, those most severely affected are referred for orthopaedic surgery. Long waiting times for treatment leads to the development of chronic debilitating pain, poor quality of life with negative impacts on patients’ mental health.
Despite surgical removal of the peripheral degenerative knee joint, some patients report ongoing pain post- surgery. This has been suggested to be caused by ongoing sensitivity of a patient’s nervous system, whereby their central nervous system reacts disproportionately to usually non-harmful stimuli e.g light pressure or has altered detection of stimuli e.g. vibration.
Studies have shown that the presence of increased pain sensitivity and severity before surgery, may help to predict the likelihood of a poorer outcome.
The aim of this PhD is to explore if measuring pain sensitivity can be used to predict outcomes post-surgery.
The proposed project will consist of four studies:
Study 1: A systematic review + meta-analysis to explore the current evidence-base for the use of pain profiling of pain sensitivity in patients with chronic musculoskeletal pain including knee OA.
Study 2: Identify patients from an existing data set and explore psychological and physical variables and map to patient reported outcomes.
Study 3: Identify a subset of patients with both positive and negative outcomes within study 2 and map their psychological and pain profiles using a procedure that the student will receive training for.
Study 4: Identify a cohort of patients waiting for knee surgery and assess these patients pre- and post-operatively. The study will capture the patients’ pain profile, and standard physical and psychological outcomes, pre- and post-operatively.
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