Fibromyalgia syndrome – a risk factor for poor outcomes following orthopaedic surgery: A systematic review
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Date
2021-06-09
Authors
D'Onghia, Martina
Ciaffi, Jacopo
McVeigh, Joseph G.
Di Martino, Alberto
Faldini, Cesare
Ablin, Jacob N.
Meliconi, Riccardo
Ursini, Francesco
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Publisher
Elsevier
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Abstract
Background: Fibromyalgia (FM) is a complex syndrome incorporating many features associated with poor outcome in orthopaedic surgery. Aim of the present review was to comprehensively characterize the available evidence on the consequences of pre-existent FM on the outcomes of orthopaedic surgery.
Methods: We performed a systematic search in MedLine and Web of Science (WOS) to identify studies evaluating the effect of FM on patient-centred outcomes, opioids consumption and postoperative complications.
Results: The search strategy identified 519 records in PubMed and 507 in WOS. A total of 27 articles were deemed eligible for inclusion in qualitative synthesis. Based on quality assessment, 10 studies were rated as good quality, 10 as fair quality and 7 as poor quality. Studies reporting the prevalence of FM in consecutive patients undergoing orthopaedic surgery (n = 19) were included in quantitative synthesis. The pooled prevalence of FM in patients undergoing orthopaedic surgery was 4.1% (95% CI: 2.4–6.8) in those receiving hip or knee surgery, 10.1% (95% CI: 5.7–17.2) in those receiving shoulder or elbow surgery and 21.0% (95% CI: 18.5–23.7) in those receiving spinal surgery. The results of our systematic review consistently report FM as a significant risk factor for less satisfaction, higher pain, worse functional outcome, increased risk for postoperative opioids prescription and higher rate of medical and surgical complications following orthopaedic surgery.
Conclusion: Identifying pre-existing FM in patients scheduled for elective orthopaedic surgery may help to better assess the benefit/risk ratio, improve patients’ awareness and minimize any discrepancy between expectancy and results.
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Keywords
Fibromyalgia , Widespread pain , Orthopaedic surgery , Knee arthroplasty , Hip arthroplasty , Spinal surgery
Citation
D’Onghia, M., Ciaffi, J., McVeigh, J.G., Di Martino, A., Faldini, C., Ablin, J.N., Meliconi, R. and Ursini, F. (2021) ‘Fibromyalgia syndrome – a risk factor for poor outcomes following orthopaedic surgery: A systematic review’, Seminars in Arthritis and Rheumatism, 51(4), pp. 793–803. Available at: https://doi.org/10.1016/j.semarthrit.2021.05.016.