The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study
Abstract Background Total knee arthroplasty (TKA) is an established surgical procedure for severe knee osteoarthritis (KOA) that has provided excellent outcomes. While several studies have reported that patients with preoperative central sensitization (CS) experienced worse pre- and post-operative p...
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BMC
2025-03-01
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| Series: | Knee Surgery & Related Research |
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| Online Access: | https://doi.org/10.1186/s43019-025-00263-8 |
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| author | Tatsuru Sonobe Takuya Nikaido Miho Sekiguchi Yoichi Kaneuchi Tadashi Kikuchi Yoshihiro Matsumoto |
| author_facet | Tatsuru Sonobe Takuya Nikaido Miho Sekiguchi Yoichi Kaneuchi Tadashi Kikuchi Yoshihiro Matsumoto |
| author_sort | Tatsuru Sonobe |
| collection | DOAJ |
| description | Abstract Background Total knee arthroplasty (TKA) is an established surgical procedure for severe knee osteoarthritis (KOA) that has provided excellent outcomes. While several studies have reported that patients with preoperative central sensitization (CS) experienced worse pre- and post-operative pain and outcomes, the evidence is limited. We conducted this study to determine the impact of CS on perioperative knee pain in TKA for severe KOA. Methods A retrospective cohort study of 66 patients who underwent bilateral TKA for bilateral severe KOA was conducted. Multiple linear regression models that included covariates and scaled estimated regression coefficients were used to examine the impact of CS on the patients’ pre- and post-operative pain subscale values on the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the improvement of KOOS pain. Postoperative KOOS pain was assessed at 3 months postoperatively, while other evaluation items including preoperative KOOS pain, CS, and pain self-efficacy were assessed on admission. Results CS had a negative impact on pre- and post-operative KOOS pain (preoperative, β: −0.28, 95% confidence interval [CI] −18.53, −0.92; postoperative, β: −0.26, 95%CI −14.09, −0.44; p < 0.05). High pain self-efficacy had a positive impact on preoperative KOOS pain (β: 0.25, 95%CI 0.32, 18.08; p < 0.05). However, CS did not influence the improvement of KOOS pain. Conclusions These results demonstrate that CS had a negative impact on pre- and post-TKA knee pain in patients but did not affect the improvement of knee pain. TKA provides sufficient pain relief for severe KOA, with or without CS. Further research is required to improve pre- and post-operative knee pain in KOA patients with CS. |
| format | Article |
| id | doaj-art-28ad25bd221c422fb25fce74e8aed2de |
| institution | Kabale University |
| issn | 2234-2451 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj-art-28ad25bd221c422fb25fce74e8aed2de2025-08-20T03:41:40ZengBMCKnee Surgery & Related Research2234-24512025-03-013711710.1186/s43019-025-00263-8The impact of central sensitization on perioperative pain in TKA: a retrospective cohort studyTatsuru Sonobe0Takuya Nikaido1Miho Sekiguchi2Yoichi Kaneuchi3Tadashi Kikuchi4Yoshihiro Matsumoto5Department of Orthopedic Surgery, Fukushima Medical University School of MedicineDepartment of Orthopedic Surgery, Fukushima Medical University School of MedicineDepartment of Orthopedic Surgery, Fukushima Medical University School of MedicineDepartment of Orthopedic Surgery, Fukushima Medical University School of MedicineDepartment of Orthopedic Surgery, Bange-Kosei General HospitalDepartment of Orthopedic Surgery, Fukushima Medical University School of MedicineAbstract Background Total knee arthroplasty (TKA) is an established surgical procedure for severe knee osteoarthritis (KOA) that has provided excellent outcomes. While several studies have reported that patients with preoperative central sensitization (CS) experienced worse pre- and post-operative pain and outcomes, the evidence is limited. We conducted this study to determine the impact of CS on perioperative knee pain in TKA for severe KOA. Methods A retrospective cohort study of 66 patients who underwent bilateral TKA for bilateral severe KOA was conducted. Multiple linear regression models that included covariates and scaled estimated regression coefficients were used to examine the impact of CS on the patients’ pre- and post-operative pain subscale values on the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the improvement of KOOS pain. Postoperative KOOS pain was assessed at 3 months postoperatively, while other evaluation items including preoperative KOOS pain, CS, and pain self-efficacy were assessed on admission. Results CS had a negative impact on pre- and post-operative KOOS pain (preoperative, β: −0.28, 95% confidence interval [CI] −18.53, −0.92; postoperative, β: −0.26, 95%CI −14.09, −0.44; p < 0.05). High pain self-efficacy had a positive impact on preoperative KOOS pain (β: 0.25, 95%CI 0.32, 18.08; p < 0.05). However, CS did not influence the improvement of KOOS pain. Conclusions These results demonstrate that CS had a negative impact on pre- and post-TKA knee pain in patients but did not affect the improvement of knee pain. TKA provides sufficient pain relief for severe KOA, with or without CS. Further research is required to improve pre- and post-operative knee pain in KOA patients with CS.https://doi.org/10.1186/s43019-025-00263-8Knee osteoarthritisCentral sensitizationTotal knee arthroplastyKOOS painSelf-efficacy |
| spellingShingle | Tatsuru Sonobe Takuya Nikaido Miho Sekiguchi Yoichi Kaneuchi Tadashi Kikuchi Yoshihiro Matsumoto The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study Knee Surgery & Related Research Knee osteoarthritis Central sensitization Total knee arthroplasty KOOS pain Self-efficacy |
| title | The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study |
| title_full | The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study |
| title_fullStr | The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study |
| title_full_unstemmed | The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study |
| title_short | The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study |
| title_sort | impact of central sensitization on perioperative pain in tka a retrospective cohort study |
| topic | Knee osteoarthritis Central sensitization Total knee arthroplasty KOOS pain Self-efficacy |
| url | https://doi.org/10.1186/s43019-025-00263-8 |
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