{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:16Z","timestamp":1740126796420,"version":"3.37.3"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom Med Psychol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\nZiel der Studie Trotz erfolgreicher Operation klagt ungef\u00e4hr jeder F\u00fcnfte Patient nach einem Kniegelenkersatz fortw\u00e4hrend \u00fcber chronische Schmerzen. Vorangegangene Studien diskutieren in diesem Zusammenhang, dass operative Eingriffe bei einigen Patienten postoperativen traumatischen Stress ausl\u00f6sen. In dieser explorativen Untersuchung soll festgestellt werden, ob nach Totalem Kniegelenkersatz postoperative Dissoziation als Ausdruck von postoperativen traumatischem Stress (neu)auftritt. Au\u00dferdem soll untersucht werden, ob diese Patienten nach einem Jahr h\u00e4ufiger chronische postoperative Schmerzen aufweisen und inwiefern sich der Schmerzverlauf zu den anderen Patienten unterscheidet.<\/jats:p><jats:p>\nMethodik Es wurden 201 Patienten untersucht, die eine prim\u00e4re Knie-TEP erhielten. Sie beantworteten zu 3 Messzeitpunkten u.\u2009a. Frageb\u00f6gen zu Knie-Schmerzen (WOMAC) und zur Feststellung von Dissoziation (FDS-20): 1 Tag pr\u00e4operativ (T1), 10 Wochen postoperativ (T2) und 1 Jahr postoperativ (T3).<\/jats:p><jats:p>\nErgebnisse In die Analysen wurden 145 Patienten eingeschlossen. Die Inzidenz von postoperativer Dissoziation betr\u00e4gt 8,3%. Dabei berichten die Patienten mit postoperativer Dissoziation nicht nur h\u00e4ufiger \u00fcber chronische postoperative Schmerzen nach einem Jahr (p=0,016), sondern der Schmerz reduziert sich postoperativ auch in einem geringerem Ma\u00df als bei den Patienten ohne postoperative Dissoziation (p=0,025).<\/jats:p><jats:p>\nDiskussion Die Befunde liefern Indizien daf\u00fcr, dass postoperative Dissoziation als Ausdruck von postoperativem traumatischen Stress nach Totalem Kniegelenkersatz neuauftritt. Auch wenn Dissoziation kurzfristig ein Abwehrmechanismus zur Regulation von unertr\u00e4glichen Affekten zu sein scheint, geht sie langfristig mit mehr chronischen postoperativen Schmerzen einher. Die Patienten mit postoperativer Dissoziation profitieren dar\u00fcber hinaus weniger in einem 1-j\u00e4hrigen follow up von einem Totalem Kniegelenkersatz hinsichtlich der Schmerzreduktion.<\/jats:p><jats:p>\nSchlussfolgerung Strategien zur Verringerung der Dissoziation k\u00f6nnten zu st\u00e4rkerer Schmerzreduktion nach Knie-TEP Implementierung f\u00fchren und sollten in zuk\u00fcnftigen Interventionsstudien untersucht werden.<\/jats:p>","DOI":"10.1055\/a-1375-0984","type":"journal-article","created":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T23:40:20Z","timestamp":1616888420000},"page":"328-334","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Dissoziation nach Totalem Kniegelenkersatz und ihr Einfluss auf den Schmerzverlauf"],"prefix":"10.1055","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4654-1561","authenticated-orcid":false,"given":"Lydia","family":"Frenzel","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Psychosomatische Medizin und Psychotherapie, Universit\u00e4tsklinikum Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Vogel","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Psychosomatische Medizin und Psychotherapie, Universit\u00e4tsklinikum Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2336-6684","authenticated-orcid":false,"given":"Christian","family":"Riediger","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Orthop\u00e4die, Universit\u00e4tsklinikum Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Frommer","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Psychosomatische Medizin und Psychotherapie, Universit\u00e4tsklinikum Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Lohmann","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Orthop\u00e4die, Universit\u00e4tsklinikum Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Illiger","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Orthop\u00e4die, Universit\u00e4tsklinikum Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,3,27]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/S0140-6736(14)60802-3","article-title":"Osteoarthritis","volume":"386","author":"S Glyn-Jones","year":"2015","journal-title":"The Lancet"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s11999-009-1119-9","article-title":"Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?","volume":"468","author":"R B Bourne","year":"2010","journal-title":"Clinical Orthopaedics and Related Research\u00ae"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.bja.2018.05.070","article-title":"Persistent postoperative pain after total knee arthroplasty: a prospective cohort study of potential risk factors","volume":"121","author":"D A Rice","year":"2018","journal-title":"British journal of anaesthesia"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1093\/brain\/awq068","article-title":"The symptom of functional weakness: a controlled study of 107 patients","volume":"133","author":"J Stone","year":"2010","journal-title":"Brain"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"385","DOI":"10.18071\/isz.71.0385","article-title":"Psychoform and somatoform dissociative experiences in migraine: relationship with pain perception and migraine related disability","volume":"71","author":"Y Sengul","year":"2018","journal-title":"Ideggyogy Sz"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1023\/A:1012958206465","article-title":"Dissociation and posttraumatic stress symptoms in patients with chronic pain","volume":"5","author":"M P Duckworth","year":"2000","journal-title":"International Journal of Rehabilitation and Health"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1026\/02803-000","volume-title":"Diagnostisches und Statistisches Manual Psychischer St\u00f6rungen DSM-5","year":"2018","edition":"2. 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