ArticleMusculoskeletal care2021
High levels of preoperative pain and fatigue are red flags for moderate-severe pain 12 months after total knee arthroplasty-A longitudinal cohort study.
Article in Musculoskeletal care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis.PloS one · 2023Pooled it
- A Systematic Review of Pain Drawings for Perioperative Patient Management.Plastic and reconstructive surgery. Global open · 2026Article
- The global profile of individuals undergoing total knee replacement surgery through a PROGRESS-PLUS equity lens: A systematic review.The South African journal of physiotherapy · 2026Review
- Article
- A multi-disciplinary program for opioid sparse arthroplasty results in reduced long-term opioid consumption: a four year prospective study.BMC anesthesiology · 2023Observational
- The duration of postoperative analgesic use after total knee arthroplasty and nomogram for predicting prolonged analgesic use.Frontiers in surgery · 2022Article
- Electroacupuncture as an Adjuvant Approach to Rehabilitation during Postacute Phase after Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Evidence-based complementary and alternative medicine : eCAM · 2021Review
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Authors and funding
7 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundModerate/severe pain after total knee arthroplasty (TKA) is a poor surgical outcome. Many studies have identified preoperative risk factors of pain after TKA, but studies of the joint contributions of co-occurring symptoms are lacking.
methodsPatients undergoing primary TKA (n = 202) were enrolled in a longitudinal cohort study. Preoperatively, patients completed questionnaires measuring demographics and symptoms (pain, fatigue, sleep problems and depression). Pain was re-assessed 12 months after TKA. Logistic regression analysis was used to compute the probabilities of moderate-severe pain at 12 months based on preoperative symptom levels, and results were combined into a risk matrix.
resultsMore than one-third (40%) of patients (n = 187) reported moderate-severe pain after TKA. Among preoperative risk factors included in the logistic regression analyses were age, sex, pain, fatigue, sleep problems and depression. Adjusting for possible confounders, fatigue (p = 0.02) and pain (p = 0.01) were significant risk factors for moderate-severe pain at 12-months follow-up and were retained in the final risk matrix. The co-occurrence of high-preoperative fatigue and pain scores resulted in 57% estimated probability of moderate-severe pain at 12 months. Similarly, the co-occurrence of low-preoperative fatigue and pain scores resulted in 14% estimated probability of moderate-severe pain 12 months after TKA.
conclusionThe combination of high fatigue and pain scores prior to surgery was a key risk factor for moderate-severe pain 12 months after TKA. Mapping of these factors could be used preoperatively to identify patients who are at risk to experience a poor outcome of TKA.
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