title: Preoperative predictors of pain following total knee arthroplasty.
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.
authors.affiliation: Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
authors.forename: Nicolas O
authors.initials: NO
authors.lastname: Noiseux
authors.affiliation: Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
authors.forename: John J
authors.initials: JJ
authors.lastname: Callaghan
authors.affiliation: Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Clark
authors.affiliation: College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, Iowa.
authors.forename: M Bridget
authors.initials: MB
authors.lastname: Zimmerman
authors.affiliation: College of Medicine, Department of Physical Therapy and Rehabilitation, University of Iowa, Iowa City, Iowa.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sluka
authors.affiliation: College of Nursing, University of Iowa, Iowa City, Iowa.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Rakel
mesh_terms: D000368:Aged; D001007:Anxiety / Q000503:physiopathology; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D058443:Catastrophization; D003863:Depression / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000523:psychology; D011184:Postoperative Period; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012044:Regression Analysis
keywords: anxiety; depression; pain catastrophizing; pain range-of-motion; predictors of pain; total knee arthroplasty