title: Risk Assessment for Chronic Pain and Patient Satisfaction After Total Knee Arthroplasty.
abstract: The estimated prevalence of patients who report minor or no improvement of their symptoms and pain after total knee arthroplasty (TKA) remains high, ranging from 5% to 40%. The authors sought to determine whether chronic pain and functional health are related to specific variations in demographic data, surgical techniques, or radiographic pre- and postoperative findings. They also sought to identify independent risk factors for persistent moderate-to-severe chronic pain after TKA. A total of 273 patients who underwent primary TKA from October 2007 to March 2010 with a minimum follow-up of 1 year were identified from electronic medical records. A questionnaire to identify persistent postoperative pain (36-item Short Form Health Survey [SF-36]) was mailed to these patients. Linear regression and logistic regression were used to identify predictors for SF-36 and chronic pain, respectively. Thirty-nine percent of patients reported persistent pain after TKA, with a median average pain score of 3 out of 10 and worst pain score of 5 out of 10. Independent risk factors for persistent pain are the length of the operative procedure (odds ratio [OR]=1.013), medical history of diabetes mellitus (OR=0.430), presence of preoperative flexion contracture (OR=1.089), and patellofemoral joint overstuffing (OR=0.915). Persistent postoperative pain is a common finding after TKA. Nonmodifiable risk factors could be used for risk stratification, whereas modifiable risk factors could be used as a clinical guidance for modification of some aspects of existing surgical techniques.
authors.forename: Vasileios I
authors.initials: VI
authors.lastname: Sakellariou
authors.forename: Lazaros A
authors.initials: LA
authors.lastname: Poultsides
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.forename: James
authors.initials: J
authors.lastname: Bae
authors.forename: Spencer
authors.initials: S
authors.lastname: Liu
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
mesh_terms: D018771:Arthralgia / Q000209:etiology*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D059350:Chronic Pain / Q000209:etiology*; D003286:Contracture / Q000150:complications; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006304:Health Status; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D017060:Patient Satisfaction; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires