ArticlePain reports
Conditioned pain modulation predicts persistent pain after knee replacement surgery.
Article in Pain reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01811888 (Painful Knee Prosthesis. Relationship Between Endogenous Analgesia and Persistent Post Surgical Pain.), which is not on this map. Cited by 14 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Painful Knee Prosthesis. Relationship Between Endogenous Analgesia and Persistent Post Surgical Pain.
Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- What proportion of people have long-term pain after total hip or knee replacement? An update of a systematic review and meta-analysis.BMJ open · 2025Pooled it
- Noninvasive brain stimulation beyond the motor cortex: a systematic review and meta-analysis exploring effects on quantitative sensory testing in clinical pain.Pain medicine (Malden, Mass.) · 2025Pooled it
- Systematic Review of Methods for Individual Prediction of Postoperative Pain.Pain research & management · 2025Pooled it
- An overview of systematic reviews examining the quantitative sensory testing-derived hypoalgesic effects of manual therapy for musculoskeletal pain.The Journal of manual & manipulative therapy · 2024Pooled it
- 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
- Conditioned Pain Modulation, Placebo and Offset Analgesia: Rates of Behavioural Expression of Inhibitory, Nonresponse and Facilitatory Pain Modulatory Effects.European journal of pain (London, England) · 2025Article
- Conditioned Pain Modulation in Patients with Hemophilic Arthropathy: A Cross-Sectional Cohort Study.Journal of clinical medicine · 2025Article
- Diffuse Noxious Inhibitory Controls in Chronic Pain States: Insights from Pre-Clinical Studies.International journal of molecular sciences · 2025Review
- The Endogenous Pain Modulatory System as a Healing Mechanism: A Proposal on How to Measure and Modulate It.NeuroSci · 2024Review
- Mechanical hyperalgesia and neuropathic pain qualities impart risk for chronic postoperative pain after total knee replacement.medRxiv : the preprint server for health sciences · 2024Article
- Sensory phenotypes in complex regional pain syndrome and chronic low back pain-indication of common underlying pathomechanisms.Pain reports · 2023Article
- Massachusetts' opioid limit law associated with a reduction in postoperative opioid duration among orthopedic patients.Health affairs scholar · 2023Article
- Neuropathic-like symptoms and central sensitization related signs and symptoms negatively affect the functional performance of patients with knee osteoarthritis - a cross-sectional study.Osteoarthritis and cartilage open · 2023Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPersistent pain after total knee replacement is an underestimated outcome leading to significant health burden. Sensory testing has been explored to help surgeons in decision making and better patient selection. Patients with different chronic pain syndromes exhibit a poor descending pain inhibition that can be quantified through experimental paradigms (conditioned pain modulation). A poor preoperative descending pain inhibition response predicted persistence of pain after surgery in previous studies.
methodsThis study investigated the correlation between a preoperative inefficient endogenous analgesia and a bad postoperative pain outcome (painful prosthesis). One hundred forty-six patients were studied preoperatively by quantitative sensory testing. Conditioned pain modulation was calculated as the relative decrease in pain intensity (thermal stimulus) during heterotopic painful stimulation.
resultsApproximately 21.2% of patients had a bad pain outcome (painful prosthesis), 6 months after surgery. Preoperatively, 47.9% of patients exhibited an insufficient endogenous analgesia. The probability to develop persistent pain after surgery in that group was higher than that in patients with a sufficient endogenous analgesia (31.4% [20.9-43.6, 95% CI] vs 11.8% [5.5-21.3, 95% CI], respectively;
conclusionsThis cohort study shows that preoperative sensory testing predicts a bad pain outcome after total knee replacement. This tool could help clinicians in a better indication of patients with advanced knee osteoarthritis for replacement surgery. REGISTRATION DETAILS: ClinicalTrials.gov: NCT01811888 (prospective).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.