JMIR Publications

ABSTRACT

Background:

Patient-reported outcome measures (PROMs) are standardized tools for assessing symptoms and the quality of care. Despite their growing use, conventional data collection methods limit widespread PROM implementation. In orthopaedics, pain is a frequent patient complaint and a common PROM, especially following total knee arthroplasty (TKA). Although TKA is generally successful, some patients still report post-operative pain, potentially due to tourniquet use. Using an improved PROM data-gathering technique may help to address tourniquet use during a TKA procedure and its impact on post-operative pain. The PainPad, an automated self-logging device, was developed to capture patient pain levels accurately.

Objective:

To assess the feasibility and effectiveness of the PainPad device in quantifying in-hospital post-operative pain following TKA with or without tourniquet use.

Methods:

A retrospective study with 234 patients who underwent TKA from 2018 to 2021 at Milton Keynes University Hospital was conducted. Patients were categorized as receiving TKA with an intra-operative tourniquet (tourniquet group) or TKA without a tourniquet (non-tourniquet group). Twenty-four-hour post-operative pain was collected bi-hourly and was self-reported using the PainPad device. From both groups, data on hospital length of stay (LOS), total tourniquet time, and the presence of post-operative deep vein thrombosis were also collected.

Results:

There were 115 TKAs with tourniquets (63% females, mean age 69.2 years) and 119 TKAs without tourniquets (76% females, mean age: 71 years). When assessing 24-hour mean post-operative pain scores, the PainPad device data indicated no significant difference (P = .53, 95% CI: -0.76 to 0.39) between the tourniquet (mean pain score: 3.31 ± 2.34) and non-tourniquet groups (mean pain score: 3.12 ± 2.15). There was no correlation between tourniquet times and the pain scores retrieved from the PainPad device. A subgroup analysis comparing longer (>90 minutes) vs. shorter (<90 min) tourniquet times showed no significant difference in terms of pain and LOS.

Conclusions:

The PainPad device is a feasible and effective method for collecting and evaluating in-hospital postoperative pain following total knee arthroplasty (TKA), allowing for the quantification of individual pain levels. This study aligns with the current healthcare trend towards leveraging innovative technologies and personalized data to enhance patient-centered care. Clinical Trial: N/A