ArticlePain medicine (Malden, Mass.)2024
Oxidative stress mediates associations between preoperative psychosocial phenotype and pain-related outcomes at 6 months following total knee arthroplasty: a longitudinal cohort study.
Article in Pain medicine (Malden, Mass.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 3 citations in OpenAlex.
- Baseline Inflammatory Cytokines Moderate Associations Between Intraoperative Oxidative Stress and Chronic Postsurgical Pain After Total Knee Arthroplasty: An Exploratory Study.Journal of pain research · 2026Article
- Objective functional performance 1 year after total knee arthroplasty does not differ for patients with symptoms of anxiety, depression or pain catastrophizing: A prospective study of 289 patients.Journal of experimental orthopaedics · 2026Article
- Effect of Preoperative Pain Catastrophizing on Postpartum Depression and Chronic Postsurgical Pain After Cesarean Section: A Prospective Cohort Study.Journal of pain research · 2026Article
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9 authors at 1 institution in 1 country.
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Abstract
objectiveGreater preoperative depression, anxiety, and pain catastrophizing are associated with more severe long-term pain following total knee arthroplasty (TKA). In a secondary analysis of previously reported data, we tested the hypothesis that these associations are mediated by oxidative stress (OS).
designA mixed between/within-subjects longitudinal cohort design.
settingA single academic medical center. SUBJECTS: Osteoarthritis patients (n = 91; 62.6% female) undergoing unilateral TKA.
methodsWe assessed depression, anxiety, and catastrophizing, as well as markers of central sensitization (widespread pain, temporal summation of pain) preoperatively. Blood samples were then obtained immediately prior to intraoperative tourniquet placement for quantification of in vivo biomarkers of systemic OS, F2-isoprostanes and isofurans. Post-TKA pain intensity (numeric rating scale worst pain [NRS], McGill Pain Questionnaire-2 [MPQ-2]) and function (PROMIS Pain Interference) were assessed at 6 months following TKA.
resultsGreater preoperative depression, catastrophizing, and widespread pain were associated with higher intraoperative combined OS (F2-isoprostanes+isofurans/2), which was in turn associated with higher post-TKA pain intensity and worse function (P < .05). All preoperative phenotype predictors except anxiety were correlated positively with post-TKA pain and/or function (P < .05). Bootstrapped mediation analyses revealed significant (P < .05) indirect (mediated) effects of depression (NRS Worst Pain, MPQ-2, PROMIS Pain Interference), anxiety (MPQ-2, PROMIS Pain Interference), and catastrophizing (PROMIS Pain Interference) on adverse long-term post-TKA outcomes via elevated OS. Central sensitization-related predictors demonstrated only direct effects (P < .05) on post-TKA outcomes that were independent of OS mechanisms.
conclusionsResults suggest that the adverse impact of depression, anxiety, and pain catastrophizing on post-TKA pain and functional outcomes are mediated in part by elevated OS.
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