Does the preoperative presence of central sensitization affect sleep quality and pain after total knee arthroplasty?

This study aims to investigate the presence of central sensitization before total knee arthroplasty (TKA) in patients with knee osteoarthritis, to explore its relationship with sleep quality after this surgery, and to evaluate postoperative pain intensity, neuropathic pain, anxiety, depression, and functional status.

Between May 2022 and May 2023, a total of 31 patients (8 males, 23 females; mean age: 68.1±2.8 years; range, 62 to 73 years) who underwent a radiographic examination, had Stage 3-4 osteoarthritis based on the Kellgren-Lawrence classification, and had TKA indications at the discretion of the orthopedic surgeon were included in this single-center, one-group, quasi-experimental, prospective study. The Central Sensitization Inventory (CSI) and International Physical Activity Questionnaire-Short Form (IPAQ) were used to evaluate patients scheduled for TKA due to osteoarthritis of the related joint. The Visual Analog Scale (VAS), painDETECT, the Pittsburgh Sleep Quality Index (PSQI), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Hospital Anxiety and Depression Scale were applied to all patients preoperatively and at one and three months postoperatively.

The postoperative PSQI, VAS, and painDETECT scores were significantly higher in those with central sensitization compared to non-central sensitization group after surgery (p<0.001). The CSI score had a positive correlation with the PSQI, VAS, and painDETECT scores, and a negative correlation with the preoperative IPAQ score (p<0.05).

Our study results suggest that, in patients with knee osteoarthritis waiting for TKA, central sensitization status has an adverse impact on postoperative pain and sleep quality.