Preoperative predictors of pain following total knee arthroplasty

Noiseux, Nicolas O.; Callaghan, John J.; Clark, Charles R.; Zimmerman, M. Bridget; Sluka, Kathleen A.; Rakel, Barbara A.

doi:10.1016/j.arth.2014.01.034

Cited by 109Total Knee Arthroplasty OutcomesAnesthesia and Pain ManagementMusculoskeletal pain and rehabilitation

Preoperative predictors of pain following total knee arthroplasty

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Noiseux, Nicolas O., Callaghan, John J., Clark, Charles R., Zimmerman, M. Bridget, Sluka, Kathleen A., Rakel, Barbara A.·2014·The Journal of Arthroplasty

DOI 10.1016/j.arth.2014.01.034PMC PMC4065835

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Abstract

Total knee arthroplasty has provided dramatic improvements in function and pain for the majority of patients with knee arthritis, yet a significant proportion of patients remain dissatisfied with their results. We performed a prospective analysis of 215 patients undergoing TKA who underwent a comprehensive array of evaluations to discover whether any preoperative assessment could predict high pain scores and functional limitations postoperatively. Patients with severe pain with a simple knee range-of-motion test prior to TKA had a 10 times higher likelihood of moderate to severe pain at 6 months. A simple test of pain intensity with active flexion and extension preoperatively was a significant predictor of postoperative pain at 6 months after surgery. Strategies to address this particular patient group may improve satisfaction rates of TKA.

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High pre-surgical pain, depression, and anxiety are risk factors for chronic post-surgical pain and prolonged opioid use.
“particular risk factors (high pre-surgical pain, depression, and anxiety) that put patients at risk for chronic post-surgical pain and prolonged opioid use31”
From Acceptance and Commitment Therapy for Prevention of Chronic Postsurgical Pain and Opioid Use in At-Risk Veterans: A Pilot Randomized Controlled Study. (2018) · cites this paper as [31]
The Discussion reports that severe preoperative pain, depression, and anxiety were associated with pain six months after total knee arthroplasty, though depression was significant only in the univariate analysis. The paper does not establish that these factors predict prolonged opioid use; its Introduction mentions only an earlier report on immediate postoperative analgesic intake. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Pain, depression, and anxiety affect orthopedic surgery outcomes.
“Mounting evidence indicates that pain, depression, and anxiety impact orthopedic surgery outcomes (Lewis, Rice, McNair, & Kluger, 2015; Noiseux et al., 2014).”
From Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery. (2020) · cites this paper as Noiseux et al., 2014
Preoperative pain, depression, and anxiety indicate risk for persistent post-surgical pain.
“Preoperative risk criteria were defined based on findings that preoperative pain, depression, and anxiety infer risk for persistent post-surgical pain (Lewis et al., 2015; Noiseux et al., 2014).”
From Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery. (2020) · cites this paper as Noiseux et al., 2014
Patients with significant preoperative anxiety or depression are at elevated risk that their pain will persist after surgery.
“Additionally, patients with significant psychological distress (anxiety and/or depression) prior to surgery are at high risk of having their pain persist after surgery103731.”
From Acceptance and Commitment Therapy for Prevention of Chronic Postsurgical Pain and Opioid Use in At-Risk Veterans: A Pilot Randomized Controlled Study. (2018) · cites this paper as [31]

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Patient Specific Alignment, Anatomy, Recovery and Outcome in Total Knee Arthroplasty
Twiggs, J. (2018) · The Sydney eScholarship Repository (The University of Sydney) · Cited by 1 · see citing works
Pain Management in Total Knee Arthroplasty: A Surgeon-Anesthesiologist Cooperation
Adravanti, P., Calafiore, G., & Ampollini, A. (2014) · Springer eBooks · doi:10.1007/978-3-319-07203-6_14
Tratamiento del dolor crónico en el perioperatorio
Belbachir, A., Olivier, M., & Estèbe, J.-P. (2018) · EMC - Anestesia-Reanimación · doi:10.1016/s1280-4703(18)41277-7

Predictors of pain following total knee arthroplasty
Rakel, B. A., Noiseux, N., Zimmerman, B., Callaghan, J. J., Clark, C. R., & Sluka, K. A. (2013) · Journal of Pain · doi:10.1016/j.jpain.2013.01.068
Self-citation
Predicting Pain after Total Knee Arthroplasty
Meding, J. B., Ritter, M. A., Keating, E. M., Berend, M. E., Faris, P. M., & Malinzak, R. A. (2010) · The Journal of Arthroplasty · doi:10.1016/j.arth.2010.01.024
A combination of high preoperative pain and low radiological grade of arthritis is associated with a greater intensity of persistent pain 12 months after total knee arthroplasty
Klasan, A., Rice, D. A., Kluger, M. T., Borotkanics, R., McNair, P. J., Lewis, G. N., & Young, S. W. (2022) · The Bone & Joint Journal · doi:10.1302/0301-620x.104b11.bjj-2022-0630.r1 · Cited by 31 · see citing works
Knee Arthroplasty
Sueyoshi, T., Lackey, W. G., Malinzak, R. A., Meding, J. B., Farris, A., DAVIS, K. E., & Ritter, M. A. (2016)
Predicting Pain in Total and Partial Knee Arthroplasty
Sueyoshi, T., Lackey, W. G., Malinzak, R. A., Meding, J. B., Farris, A., DAVIS, K. E., & Ritter, M. A. (2015) · Open Journal of Orthopedics · doi:10.4236/ojo.2015.56020 · Cited by 3 · see citing works

Authors: Noiseux, N. O., Callaghan, J. J., Clark, C. R., Zimmerman, M. B., Sluka, K. A., & Rakel, B. A.
Affiliations: University of Iowa (US)
Corresponding author: Noiseux, Nicolas O.
ORCID: Callaghan, John J.
Clark, Charles R.
Sluka, Kathleen A.
Rakel, Barbara A.
Venue: The Journal of Arthroplasty
Publisher: Elsevier BV
Published: 2014-07
Volume: 29
Issue: 7
Pages: 1383-1387
ISSN: 0883-5403 (ISSN-L)
DOI: 10.1016/j.arth.2014.01.034
PMC: PMC4065835
OpenAlex: W2023951584
Cited by: 109
References: 56
Citations by year: 2026: 5 · 2025: 4 · 2024: 7 · 2023: 13 · 2022: 7 · 2021: 12 · 2020: 9 · 2019: 6 · 2018: 13 · 2017: 9 · 2016: 10 · 2015: 11 · 2014: 3
FWCI: 10.92
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Journal of Arthroplasty (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Iowa Research Online (The University of Iowa) (submittedVersion)
Funders: National Institute of Nursing Research (R01NR009844)
Topics: Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: total knee arthroplasty, postoperative pain, preoperative predictors, knee range of motion, knee flexion and extension, knee arthritis, patient satisfaction, functional limitations
MeSH terms: Aged, Anxiety, Depression, Female, Humans, Male, Middle Aged, Pain Measurement, Pain, Postoperative, Postoperative Pain, Postoperative Period, Prospective Studies, Regression Analysis, Range of Motion, Articular, Arthroplasty, Replacement, Knee, Catastrophization

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Preoperative predictors of pain following total knee arthroplasty

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