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- Title
OUTCOMES OF AMPUTATION DUE TO LONG-STANDING THERAPY-RESISTANT COMPLEX REGIONAL PAIN SYNDROME TYPE I.
- Authors
GEERTZEN, Jan H. B.; SCHEPER, Jelmer; SCHRIER, Ernst; DIJKSTRA, Pieter U.
- Abstract
Objective: To assess long-term outcomes of amputation in patients with long-standing therapyresistant complex regional pain syndrome type I (CRPS-I). Design: Partly cross-sectional, partly longitudinal study. Subjects: Patients who had amputation of a limb due to long-standing, therapy-resistant CRPS-I, at the University Medical Centre Groningen, The Netherlands, between May 2000 and September 2015 (n = 53) were invited to participate. Methods: Participants were interviewed in a semistructured way regarding mobility, pain, recurrence of CRPS-I, quality of life, and prosthesis use. Those who reported recurrence of CRPS-I underwent physical examination. Results: A total of 47 patients (median age at time of amputation, 41.0 years; 40 women) participated. Longitudinal evaluation was possible in 17 participants. Thirty-seven participants (77%) reported an important improvement in mobility (95% confidence interval (95% CI) 63; 87%). An important reduction in pain was reported by 35 participants (73%; 95% CI 59; 83%). CRPS-I recurred in 4 of 47 participants (9%; 95% CI 3; 20%), once in the residual limb and 3 times in another limb. At the end of the study of the 35 participants fitted with a lower limb prosthesis, 24 were still using the prosthesis. Longitudinal evaluation showed no significant deteriorations. Conclusion: Amputation can be considered as a treatment for patients with long-standing, therapyresistant CRPS-I. Amputation can increase mobility and reduce pain, thereby improving the quality of patients' lives. However, approximately one-quarter of participants reported deteriorations in intimacy and self-confidence after the amputation.
- Subjects
NETHERLANDS; EXTREMITIES (Anatomy) -- Surgery; ACADEMIC medical centers; AMPUTATION; ANXIETY; CHI-squared test; CONFIDENCE intervals; MENTAL depression; DRUG resistance; INTERVIEWING; INTIMACY (Psychology); LONGITUDINAL method; RESEARCH methodology; PAIN; PATIENT satisfaction; PHYSICAL diagnosis; QUALITY of life; QUESTIONNAIRES; COMPLEX regional pain syndromes; REOPERATION; SCALE analysis (Psychology); STATISTICS; T-test (Statistics); WOUNDS &; injuries; DISEASE relapse; DATA analysis; BODY movement; TREATMENT effectiveness; CROSS-sectional method; DATA analysis software; DESCRIPTIVE statistics; MANN Whitney U Test; SYMPTOM Checklist-90-Revised
- Publication
Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation), 2020, Vol 52, Issue 8, p1
- ISSN
1650-1977
- Publication type
Article
- DOI
10.2340/16501977-2718