Preoperative pain catastrophizing affects pain outcome after total knee arthroplasty

Preoperative widespread pain sensitization or pain catastrophizing could be associated with chronic pain after total knee arthroplasty (TKA). The aim of the present study was to examine the association between postoperative pain in patients undergoing TKA and preoperative factors, including patient characteristics and preoperative central sensitization as well as pain catastrophizing.

Preoperative TKA patients were evaluated using the Central Sensitization Inventory (CSI)-9 and Pain Catastrophizing Scale (PCS). Postoperative knee pain was evaluated using a numerical rating scale (NRS) 6 months after TKA. Statistical analyses were performed to assess the relationship between NRS 6 months after TKA and preoperative factors, including patient characteristics, CSI-9, and PCS.

We enrolled 58 consecutive patients with osteoarthritis who underwent TKA. Using cutoff of 14, postoperative NRS was higher in the patients with ≥14 than the patients with <14 in CSI (p = 0.025). Postoperative NRS was higher in the patients with ≥30 than the patients with <30 in PCS (p = 0.043). Preoperative PCS was a significant risk factor of postoperative pain using a multivariate analysis.

Surgeon should recognize preoperative PCS could affect postoperative pain 6 months after TKA.