Preoperative predictors of pain following total knee arthroplasty

J Arthroplasty. 2014 Jul;29(7):1383-7. doi: 10.1016/j.arth.2014.01.034. Epub 2014 Feb 7.

Abstract

Total knee arthroplasty has provided dramatic improvements in function and pain for the majority of patients with knee arthritis, yet a significant proportion of patients remain dissatisfied with their results. We performed a prospective analysis of 215 patients undergoing TKA who underwent a comprehensive array of evaluations to discover whether any preoperative assessment could predict high pain scores and functional limitations postoperatively. Patients with severe pain with a simple knee range-of-motion test prior to TKA had a 10 times higher likelihood of moderate to severe pain at 6 months. A simple test of pain intensity with active flexion and extension preoperatively was a significant predictor of postoperative pain at 6 months after surgery. Strategies to address this particular patient group may improve satisfaction rates of TKA.

Keywords: anxiety; depression; pain catastrophizing; pain range-of-motion; predictors of pain; total knee arthroplasty.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anxiety / physiopathology
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Catastrophization
  • Depression / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods*
  • Pain, Postoperative / diagnosis*
  • Pain, Postoperative / psychology
  • Postoperative Period
  • Prospective Studies
  • Range of Motion, Articular*
  • Regression Analysis