Abstract

Total knee arthroplasty (TKA) is the end-stage treatment of knee osteoarthritis (OA), and approximately 20% of patients experience chronic postoperative pain. Studies indicate that inflammatory biomarkers might be associated with pain in OA and potentially linked to the development of chronic postoperative pain after TKA. This study aimed to (1) evaluate preoperative serum levels of inflammatory biomarkers in patients with OA and healthy control subjects, (2) investigate preoperative differences of inflammatory biomarker profiles in subgroups of patients, and (3) compare subgroups of patients with and without postoperative pain 12 months after surgery. Serum samples from patients with OA scheduled for TKA (n 5 127) and healthy participants (n 5 39) were analyzed. Patients completed the Knee-injury-and-Osteoarthritis-Outcome-Score (KOOS) questionnaire and rated their clinical pain intensity using a visual analog scale (VAS) before and 12 months after TKA. Hierarchical cluster analysis and Orthogonal Partial Least Squares Discriminant Analysis were used to compare groups (patients vs control subjects) and to identify subgroups of patients in relation to postoperative outcomes. Difference in preoperative and postoperative VAS and KOOS scores were compared across subgroups. Twelve inflammatory markers were differentially expressed in patients when compared with control subjects. Cluster analysis identified 2 subgroups of patients with 23 proteins being significantly different (P, 0.01). The 12-months postoperative VAS and KOOS scores were significantly different between subgroups of patients (P, 0.05). This study identified differences in specific inflammatory biomarker profiles when comparing patients with OA and control subjects. Cluster analysis identified 2 subgroups of patients with OA, with one subgroup demonstrating comparatively worse 12-month postoperative pain intensity and function scores.

Original languageEnglish
JournalPain
Volume165
Issue number2
Pages (from-to)337-346
Number of pages10
ISSN0304-3959
DOIs
Publication statusPublished - 1 Feb 2024

Bibliographical note

Copyright © 2023 International Association for the Study of Pain.

Keywords

  • Arthroplasty, Replacement, Knee/adverse effects
  • Biomarkers
  • Humans
  • Knee Joint
  • Osteoarthritis, Knee/complications
  • Pain, Postoperative/etiology
  • Treatment Outcome
  • Postoperative pain
  • Knee osteoarthritis
  • Preoperative pain
  • Functional outcomes
  • Pain
  • Inflammation biomarker
  • Proteomics

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