Preoperative predictors of postoperative opioid usage, pain scores, and referral to a pain management service in total knee arthroplasty.
BACKGROUND
Little is known about preoperative predictors of postoperative pain and referral to a recuperative pain management service after total knee arthroplasty (TKA).


OBJECTIVE
We sought to identify the preoperative predictors of postoperative pain scores, referral to a pain management service, and narcotic usage in patients undergoing primary total knee arthroplasty.


METHODS
We performed a prospective cohort study of 97 TKAs from a single surgeon. Pre and 6-week postoperative WOMAC, visual analog pain scale (VAS) scores, narcotic usage, and catastrophizing pain scores were collected.


RESULTS
After adjusting for all other variables, higher age and catastrophizing pain scores were associated with lower odds of postoperative opioid usage. Increasing age and BMI were associated with lower odds of being referred to pain management. There was no relationship between self-reported preoperative pain tolerance and postoperative change in WOMAC or VAS pain scores.


CONCLUSIONS
This information may help surgeons advise their patients preoperatively and set expectations during the recovery period.
Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA ; Weill Cornell Medical College, New York, NY USA.
Trevor R
TR
Banka
Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA.
Allison
A
Ruel
Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA.
Kara
K
Fields
Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA ; Weill Cornell Medical College, New York, NY USA.
Jacques
J
YaDeau
Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA ; Weill Cornell Medical College, New York, NY USA.
Geoffrey
G
Westrich
opioid usage; outcomes; pain management; preoperative predictors; total knee arthroplasty