The Combination of Preoperative Pain, Conditioned Pain Modulation, and Pain Catastrophizing Predicts Postoperative Pain 12 Months After Total Knee Arthroplasty

Dennis Boye Larsen; Mogens Laursen; Robert R Edwards; Ole Simonsen; Lars Arendt-Nielsen; Kristian Kjær Petersen

doi:10.1093/pm/pnaa402

The Combination of Preoperative Pain, Conditioned Pain Modulation, and Pain Catastrophizing Predicts Postoperative Pain 12 Months After Total Knee Arthroplasty

Dennis Boye Larsen, Mogens Laursen, Robert R Edwards, Ole Simonsen, Lars Arendt-Nielsen, Kristian Kjær Petersen^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

OBJECTIVES: Approximately 20% of knee osteoarthritis patients undergoing total knee arthroplasty (TKA) report chronic postoperative pain. Studies suggest that preoperative variables such as impaired descending pain control, catastrophizing, function, and neuropathic pain-like symptoms may predict postoperative pain 12 months after TKA, but the combined prediction value of these factors has not been tested. The current prospective cohort study aimed to combine preoperative risk factors to investigate the predictive value for postoperative pain 12 months after TKA.

DESIGN: Prospective cohort with follow-up 12 months after surgery.

PATIENTS: A consecutive sample of 131 knee osteoarthritis patients undergoing TKA.

METHODS: Pain intensity, Pain Catastrophizing Scale (PCS) scores, PainDETECT Questionnaire scores, conditioned pain modulation (CPM), and Oxford Knee Score (OKS) were obtained before and 12 months after TKA.

RESULTS: TKA improved pain (P < 0.001), PCS scores (P < 0.001), PainDETECT Questionnaire scores (P < 0.001), and OKSs (P < 0.001). Preoperative pain correlated with preoperative PCS scores (r = 0.38, P < 0.001), PainDETECT scores (r = 0.53, P < 0.001), and OKSs (r = -0.25, P = 0.001). Preoperative PainDETECT scores were associated with preoperative PCS scores (r = 0.53, P < 0.001) and OKSs (r = -0.25, P = 0.002). Higher postoperative pain was correlated with high preoperative pain (r = 0.424, P < 0.001), PCS scores (r = 0.33, P < 0.001), PainDETECT scores (r = 0.298, P = 0.001), and lower CPM (r = -0.18, P = 0.04). The combination of preoperative pain, PCS score, and CPM explained 20.5% of variance in follow-up pain. PCS scores had a significant effect on pain trajectory when accounting for patient variance (t = 14.41, P < 0.0005).

CONCLUSION: The combination of high preoperative clinical pain intensity, high levels of pain catastrophizing thoughts, and impaired CPM may predict long-term postoperative pain 12 months after surgery.

Original language	English
Journal	Pain Medicine
Volume	22
Issue number	7
Pages (from-to)	1583-1590
Number of pages	8
ISSN	1526-2375
DOIs	https://doi.org/10.1093/pm/pnaa402
Publication status	Published - 25 Jul 2021

Bibliographical note

Free version of the article available at: https://academic.oup.com/painmedicine/article/22/7/1583/6067636

Keywords

Conditioned Pain Modulation
Knee Osteoarthritis
Osteoarthritis
Pain Catastrophizing
Total Knee Arthroplasty

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10.1093/pm/pnaa402

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@article{895950e02f4140c3997fd9ac5e5e1dfd,

title = "The Combination of Preoperative Pain, Conditioned Pain Modulation, and Pain Catastrophizing Predicts Postoperative Pain 12 Months After Total Knee Arthroplasty",

abstract = "OBJECTIVES: Approximately 20% of knee osteoarthritis patients undergoing total knee arthroplasty (TKA) report chronic postoperative pain. Studies suggest that preoperative variables such as impaired descending pain control, catastrophizing, function, and neuropathic pain-like symptoms may predict postoperative pain 12 months after TKA, but the combined prediction value of these factors has not been tested. The current prospective cohort study aimed to combine preoperative risk factors to investigate the predictive value for postoperative pain 12 months after TKA.DESIGN: Prospective cohort with follow-up 12 months after surgery.PATIENTS: A consecutive sample of 131 knee osteoarthritis patients undergoing TKA.METHODS: Pain intensity, Pain Catastrophizing Scale (PCS) scores, PainDETECT Questionnaire scores, conditioned pain modulation (CPM), and Oxford Knee Score (OKS) were obtained before and 12 months after TKA.RESULTS: TKA improved pain (P < 0.001), PCS scores (P < 0.001), PainDETECT Questionnaire scores (P < 0.001), and OKSs (P < 0.001). Preoperative pain correlated with preoperative PCS scores (r = 0.38, P < 0.001), PainDETECT scores (r = 0.53, P < 0.001), and OKSs (r = -0.25, P = 0.001). Preoperative PainDETECT scores were associated with preoperative PCS scores (r = 0.53, P < 0.001) and OKSs (r = -0.25, P = 0.002). Higher postoperative pain was correlated with high preoperative pain (r = 0.424, P < 0.001), PCS scores (r = 0.33, P < 0.001), PainDETECT scores (r = 0.298, P = 0.001), and lower CPM (r = -0.18, P = 0.04). The combination of preoperative pain, PCS score, and CPM explained 20.5% of variance in follow-up pain. PCS scores had a significant effect on pain trajectory when accounting for patient variance (t = 14.41, P < 0.0005).CONCLUSION: The combination of high preoperative clinical pain intensity, high levels of pain catastrophizing thoughts, and impaired CPM may predict long-term postoperative pain 12 months after surgery.",

keywords = "Conditioned Pain Modulation, Knee Osteoarthritis, Osteoarthritis, Pain Catastrophizing, Total Knee Arthroplasty",

author = "Larsen, {Dennis Boye} and Mogens Laursen and Edwards, {Robert R} and Ole Simonsen and Lars Arendt-Nielsen and Petersen, {Kristian Kj{\ae}r}",

note = "Free version of the article available at: https://academic.oup.com/painmedicine/article/22/7/1583/6067636 ",

year = "2021",

month = jul,

day = "25",

doi = "10.1093/pm/pnaa402",

language = "English",

volume = "22",

pages = "1583--1590",

journal = "Pain Medicine",

issn = "1526-2375",

publisher = "Oxford University Press",

number = "7",

}

The Combination of Preoperative Pain, Conditioned Pain Modulation, and Pain Catastrophizing Predicts Postoperative Pain 12 Months After Total Knee Arthroplasty. / Larsen, Dennis Boye ; Laursen, Mogens; Edwards, Robert R et al.
In: Pain Medicine, Vol. 22, No. 7, 25.07.2021, p. 1583-1590.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - The Combination of Preoperative Pain, Conditioned Pain Modulation, and Pain Catastrophizing Predicts Postoperative Pain 12 Months After Total Knee Arthroplasty

AU - Larsen, Dennis Boye

AU - Laursen, Mogens

AU - Edwards, Robert R

AU - Simonsen, Ole

AU - Arendt-Nielsen, Lars

AU - Petersen, Kristian Kjær

N1 - Free version of the article available at: https://academic.oup.com/painmedicine/article/22/7/1583/6067636

PY - 2021/7/25

Y1 - 2021/7/25

N2 - OBJECTIVES: Approximately 20% of knee osteoarthritis patients undergoing total knee arthroplasty (TKA) report chronic postoperative pain. Studies suggest that preoperative variables such as impaired descending pain control, catastrophizing, function, and neuropathic pain-like symptoms may predict postoperative pain 12 months after TKA, but the combined prediction value of these factors has not been tested. The current prospective cohort study aimed to combine preoperative risk factors to investigate the predictive value for postoperative pain 12 months after TKA.DESIGN: Prospective cohort with follow-up 12 months after surgery.PATIENTS: A consecutive sample of 131 knee osteoarthritis patients undergoing TKA.METHODS: Pain intensity, Pain Catastrophizing Scale (PCS) scores, PainDETECT Questionnaire scores, conditioned pain modulation (CPM), and Oxford Knee Score (OKS) were obtained before and 12 months after TKA.RESULTS: TKA improved pain (P < 0.001), PCS scores (P < 0.001), PainDETECT Questionnaire scores (P < 0.001), and OKSs (P < 0.001). Preoperative pain correlated with preoperative PCS scores (r = 0.38, P < 0.001), PainDETECT scores (r = 0.53, P < 0.001), and OKSs (r = -0.25, P = 0.001). Preoperative PainDETECT scores were associated with preoperative PCS scores (r = 0.53, P < 0.001) and OKSs (r = -0.25, P = 0.002). Higher postoperative pain was correlated with high preoperative pain (r = 0.424, P < 0.001), PCS scores (r = 0.33, P < 0.001), PainDETECT scores (r = 0.298, P = 0.001), and lower CPM (r = -0.18, P = 0.04). The combination of preoperative pain, PCS score, and CPM explained 20.5% of variance in follow-up pain. PCS scores had a significant effect on pain trajectory when accounting for patient variance (t = 14.41, P < 0.0005).CONCLUSION: The combination of high preoperative clinical pain intensity, high levels of pain catastrophizing thoughts, and impaired CPM may predict long-term postoperative pain 12 months after surgery.

AB - OBJECTIVES: Approximately 20% of knee osteoarthritis patients undergoing total knee arthroplasty (TKA) report chronic postoperative pain. Studies suggest that preoperative variables such as impaired descending pain control, catastrophizing, function, and neuropathic pain-like symptoms may predict postoperative pain 12 months after TKA, but the combined prediction value of these factors has not been tested. The current prospective cohort study aimed to combine preoperative risk factors to investigate the predictive value for postoperative pain 12 months after TKA.DESIGN: Prospective cohort with follow-up 12 months after surgery.PATIENTS: A consecutive sample of 131 knee osteoarthritis patients undergoing TKA.METHODS: Pain intensity, Pain Catastrophizing Scale (PCS) scores, PainDETECT Questionnaire scores, conditioned pain modulation (CPM), and Oxford Knee Score (OKS) were obtained before and 12 months after TKA.RESULTS: TKA improved pain (P < 0.001), PCS scores (P < 0.001), PainDETECT Questionnaire scores (P < 0.001), and OKSs (P < 0.001). Preoperative pain correlated with preoperative PCS scores (r = 0.38, P < 0.001), PainDETECT scores (r = 0.53, P < 0.001), and OKSs (r = -0.25, P = 0.001). Preoperative PainDETECT scores were associated with preoperative PCS scores (r = 0.53, P < 0.001) and OKSs (r = -0.25, P = 0.002). Higher postoperative pain was correlated with high preoperative pain (r = 0.424, P < 0.001), PCS scores (r = 0.33, P < 0.001), PainDETECT scores (r = 0.298, P = 0.001), and lower CPM (r = -0.18, P = 0.04). The combination of preoperative pain, PCS score, and CPM explained 20.5% of variance in follow-up pain. PCS scores had a significant effect on pain trajectory when accounting for patient variance (t = 14.41, P < 0.0005).CONCLUSION: The combination of high preoperative clinical pain intensity, high levels of pain catastrophizing thoughts, and impaired CPM may predict long-term postoperative pain 12 months after surgery.

KW - Conditioned Pain Modulation

KW - Knee Osteoarthritis

KW - Osteoarthritis

KW - Pain Catastrophizing

KW - Total Knee Arthroplasty

UR - http://www.scopus.com/inward/record.url?scp=85107213288&partnerID=8YFLogxK

U2 - 10.1093/pm/pnaa402

DO - 10.1093/pm/pnaa402

M3 - Journal article

C2 - 33411890

SN - 1526-2375

VL - 22

SP - 1583

EP - 1590

JO - Pain Medicine

JF - Pain Medicine

IS - 7

ER -

The Combination of Preoperative Pain, Conditioned Pain Modulation, and Pain Catastrophizing Predicts Postoperative Pain 12 Months After Total Knee Arthroplasty

Abstract

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