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Related Experiment Videos

Predicting total knee replacement pain: a prospective, observational study.

Victoria A Brander1, S David Stulberg, Angela D Adams

  • 1Northwestern University, Orthopedic Institute, Memorial Hospital Joint Reconstruction and Implant Service, and Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Chicago, IL 60611, USA. VictoriaBrander@aol.com

Clinical Orthopaedics and Related Research
|December 4, 2003
PubMed
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Pain after total knee replacement often resolves quickly, but some patients experience persistent moderate to severe pain. Preoperative pain, depression, and anxiety are key predictors of prolonged discomfort.

Area of Science:

  • Orthopedics
  • Pain Management
  • Rehabilitation Medicine

Background:

  • Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
  • Understanding the trajectory of postoperative pain is crucial for patient recovery and satisfaction.
  • Predicting persistent pain can guide targeted interventions.

Purpose of the Study:

  • To characterize the natural history of pain following TKA.
  • To identify preoperative and perioperative factors associated with excessive postoperative pain.

Main Methods:

  • Prospective, observational study of 116 patients (149 knees) undergoing TKA.
  • Clinical and radiographic variables assessed preoperatively and at 1, 3, 6, and 12 months post-surgery.
  • Visual analog pain scale, patient health, psychologic state, and component reliability data collected; regression analyses performed.

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Main Results:

  • Significant pain reported by 72.3% at 1 month, declining to 13.1% at 1 year.
  • Preoperative pain intensity predicted greater postoperative pain, home therapy use, and manipulations.
  • Preoperative depression and anxiety correlated with heightened pain at 1 year.
  • No significant differences in pain based on anesthesia, weight, age, or gender.

Conclusions:

  • Postoperative knee replacement pain generally resolves rapidly, with significant improvement by 3 months.
  • A notable proportion of patients (13%) experience moderate to severe pain at 1 year, often without clinical or radiographic abnormalities.
  • Preoperative screening for pain, depression, and anxiety may help identify at-risk patients for targeted interventions, potentially reducing costs and improving outcomes.