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Relating neuropathic symptoms and impaired monofilament detection to knee osteoarthritis patients following total knee replacement

Kimmel, George M (2017) Relating neuropathic symptoms and impaired monofilament detection to knee osteoarthritis patients following total knee replacement. Master Essay, University of Pittsburgh.

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Knee osteoarthritis (OA), the most common form of arthritis in the US, carries a lifetime risk of 45% in older adults. Knee OA has been associated with neuropathic symptoms, such as pain and loss of sensation, and reduced sensory peripheral nerve function (PNF). However, the relationship between knee OA and peripheral nerves remains poorly understood. We examined PNF using monofilament detection (insensitivity: unable to detect 3/4 touches of 1.4-g, 4-g and 10-g at dorsum of right and left big toe) in patients aged ≥60 years with knee OA who had unilateral total knee replacement (TKR). Patients (N=126) were 63.5% women; age 69.8±6.5 years; 2-4 months post-surgery, and had a mean Western Ontario and McMaster Universities Arthritis Index (WOMAC) score: 20.1±7.8. Conditional logistic regression was used to compare between knee differences of patients’ TKR and non-surgical knee (NSK) in separate models for 1.4-g, 4-g and 10-g monofilament insensitivity. Monofilament insensitivity was similar in the TKR knee compared to NSK: 1.4-g (31.8% vs. 29.4%), 4-g (15.9% vs. 15.1%), and 10-g (8.7% vs. 10.3%), all NS. In conditional logistic regression models, monofilament insensitivity was not different for 1.4-g (OR=1.3; 95% CI: 0.57-3.0), 4-g (OR=1.2; 95% CI: 0.39-3.5) or 10-g (OR=0.50; 95% CI: 0.09-2.7) in patients’ TKR vs. NSK. Although light touch monofilament insensitivity was highly prevalent in TKR patients, lack of differences for TKR vs. NSK suggests that knee OA rather than surgery may be responsible for PNF impairments. Future studies should include more sensitive tests of PNF in TKR patients to further elucidate the public health importance of PNF and knee OA.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kimmel, George
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancyglynnn@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberStrotmeyer, Elsastrotmeyere@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberPiva, Saraspiva@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 2017
Date Type: Completion
Number of Pages: 45
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 21 Nov 2017 15:27
Last Modified: 21 Nov 2017 15:27


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