Objective: The aim of this study was to determine the risk factors for the development of postoperative pain following total hip arthroplasty, particularly those connected with psychological distress and personality traits. Methods: The study included 90 patients with complaints of postoperative pain following cemented total hip replacement divided into two groups based on the intensity of postoperative pain as measured using the numerical rating scale (NRS). Patients with NRS scores of 5 or higher were included in the study group and those with NRS of less than 5 were included in the control group. The Hamilton scales for anxiety and depression and the DS14 test for the identification of Type D personality were used for psychological evaluation. Results: In the study group, more patients were female (29 vs. 13) and had more anxiety (13 vs. 3), depression symptoms (11 vs. 2), and Type D personality (18 vs. 9) than the control group. Mean preoperative NRS was 7.2±1.7 in the study and 6.0±1.2 in the control group (p<0.001). Factors associated with development of strong postoperative pain was female gender (OR=4.91, 95% CI=2.01 to 12.01, p<0.001), Type D personality (OR=2.81, CI=1.17 to 7.32, p=0.030), severe anxiety (OR=6.01, CI=1.58 to 22.90, p=0.009), depressive symptoms (OR=7.33, CI=1.52 to 35.34, p=0.013) and subjects with marked preoperative painful condition (OR=2.64, CI=1.17 to 5.44, p<0.001). Conclusion: Patients with severe anxiety, depression and Type D personality appear to be at risk of developing severe postoperative pain. In addition, female gender and the intensity of pain immediately after procedure were found to be important risk factors. Özet Amaç: Bu çalışmada, total kalça artroplastisi sonrası, özellikle psikolojik sıkıntı ve kişilik özellikleri ile bağlantılı gelişebilecek postoperatif ağrıya dair risk faktörlerinin belirlenmesi amaçlandı. Çalışma planı: Çimentolu total kalça replasmanı sonrası postoperatif ağrı şikayeti ile başvuran 90 hasta, sayısal değerleme ölçeği (SDÖ) ile ölçülen ağrının şiddetine göre iki gruba ayrıldı. SDÖ puanı 5 veya daha yüksek olan hastalar çalışma grubuna, 5 puanın altında kalan hastalar ise kontrol grubuna dahil edildi. Psikolojik değerlendirmede, anksiyete ve depresyon için Hamilton ölçekleri, Tip D kişiliğin saptanması için ise DS14 testinden yararlanıldı. Bulgular: Çalışma grubundaki bireylerin çoğunluğu kadındı ve anksiyete, depresyon semptomları ve Tip D kişilik özellikleri saptanan olguların kontrol grubuna kıyasla daha yüksek sayıda olduğu belirlendi (sırasıyla, 13’e karşı 3, 11’e karşı 2 ve 18’e karşı 9 olgu). Cerrahi öncesi ortalama SDÖ puanı çalışma grubunda kontrol grubunda ise olarak bulundu (p<0.001). Postoperatif ağrı gelişimiyle ilişkilendirilen faktörler kadın cinsiyet (OO=4.91, %95 GA=2.01-12.01, p<0.001), Tip D kişilik (OO=2.81, GA=1.17-7.32, p=0.030), şiddetli anksiyete (OO=6.01, GA=1.58-22.90, p=0.009), depresif semptomlar (OO=7.33, GA=1.52-35.34, p=0.013) ve cerrahi öncesi dikkat çekici derecede ağrısı bulunan olgular (OO=2.64, GA=1.17-5.44, p<0.001) oldu. Çıkarımlar: Şiddetli anksiyete, depresyon ve Tip D kişilik özelliklerine sahip olgularda şiddetli postoperatif ağrı görülme riski bulunmaktadır. Bunlar dışında, kadın cinsiyet ve cerrahiden hemen sonraki ağrı şiddetinin de önemli risk faktörleri olduğu belirlenmiştir.

Background and Objectives: The epidemiological pattern of the hip fracture burden attributable to falls in Central European countries is still insufficiently known. The aim of this study was to assess the regional and national trends of hip fractures due to falls in Central Europe from 1990 to 2019. Materials and Methods: Using the Global Burden of Disease (GBD) 2019 study, this descriptive epidemiological study presents trends in incidence of and Years Lived with Disability (YLDs) from hip fractures due to falls in the region of Central Europe. All estimates (age- and sex-specific rates, and age-standardized rates) were expressed per 100,000. A joinpoint regression analysis was used to assess trends: the average annual percent change (AAPC) with a corresponding 95% confidence interval (95% CI) was calculated. Results: Among all new cases of hip fracture in the population as a whole in Central Europe in 2019, 3.9% in males and 7.0% in females were attributable to falls, while the share of hip fractures due to falls in the population aged 70 and over was 16.9% in males and 20.0% in females. About 400,000 new cases of hip fracture due to falls occurred in the Central European region in 2019 (220,000 among males and 160,000 among females), resulting in 55,000 YLDs (32,000 in females and 22,000 in males). About one-third of all new cases (59,326 in males and 72,790 in females) and YLDs (8585 in males, and 10,622 in females) of hip fractures due to falls were recorded in Poland. From 1990 to 2019, the age-standardized incidence rates of hip fracture due to falls showed a decreasing tendency in females (AAPC = −1.1%), and an increasing tendency in males (AAPC = 0.1%). Both in males and females, YLDs rates of hip fracture due to falls in the Central European region decreased (AAPC = −1.6% and AAPC = −2.4%, respectively). Conclusions: Hip fracture due to falls represents an important health issue in the Central European region, although incidences and YLDs declined in the most recent decades. However, further efforts to reduce the burden of hip fractures attributed to falls are needed.