Beyond the joint: Measurement and treatment of sensitisation in patients undergoing total knee of hip arthroplasty

Wietske Rienstra

    Research output: ThesisThesis fully internal (DIV)

    425 Downloads (Pure)


    Osteoarthritis is one of the most common causes of pain. Why and how osteoarthritis leads to so much pain in some people is still not fully understood. In a number of people, the pain does not even go away after a hip or knee replacement. This kind pain is a complicated process involving many different factors, including increased pain sensitivity of the nerves and brain. This is called sensitization.
    The aim of this thesis was to investigate the measurement of signs of sensitization in people with hip or knee osteoarthritis. For this we have created a Dutch version of a reliable and representative questionnaire for signs of sensitization, specifically for patients with hip or knee osteoarthritis. In addition, we investigated whether targeted treatment of sensitization reduces the pain after a hip or knee replacement. The treatment consisted of duloxetine, a pain reliever that works on the brain's processing of pain. Osteoarthritis patients from the Medical Center Leeuwarden, the Martini Hospital and the UMCG participated. No effect of duloxetine treatment was found on the amount of pain remaining in patients after total hip or knee replacement. We did find that the questionnaire used to measure pain after hip or knee replacement was good at measuring change over time. We also found that after a hip or knee replacement, patients' perception of pain changes, as if their internal pain measure is being reset. This is important to consider in future studies examining pain after hip or knee replacement.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    • Bulstra, Sjoerd, Supervisor
    • van den Akker-Scheek, Inge, Supervisor
    • Stevens, Martin, Supervisor
    Award date19-May-2021
    Place of Publication[Groningen]
    Publication statusPublished - 2021

    Cite this