Preoperative risk factors associated with chronic pain profiles following total knee arthroplasty

ABSTRACT

Background

One in five patients experiences chronic pain 12 months following total knee arthroplasty (TKA). This longitudinal study used a person‐centered approach to identify subgroups of patients with distinct chronic pain profiles following TKA and identified preoperative characteristics associated with these profiles.

Methods

On the day before surgery, 202 patients completed questionnaires that assessed pain, interference with functioning, fatigue, anxiety, depression, and illness perceptions. Average and worst pain were assessed prior to surgery, on postoperative day 4, at 6 weeks, and at 3 and 12 months following surgery. Using growth mixture modeling, two subgroups with distinct average and worst pain profiles were identified.

Results

Patients in the “lower average” and “lower worst” pain classes had moderate preoperative pain scores that decreased over the remaining 9 months following TKA. Patients in the “higher average” and “higher worst” pain classes had relatively higher preoperative pain scores that increased during the first three months and then decreased slightly over the remaining 9 months. Patients in the higher pain classes had higher interference with function scores; used opioids prior to surgery more often, were more likely to receive a continuous nerve block and ketamine; had higher preoperative fatigue severity and interference scores; and had worse perceptions of illness than patients in the lower pain classes.

Conclusions

These risk factors may be used to identify subgroups of patients at higher risk for more severe pain after TKA. Future studies should test whether modifying these risk factors can improve patients’ outcomes after TKA.

from Wiley: European Journal of Pain: Table of Contents https://ift.tt/3ogRhJf
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