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Objective <p>This study aims to explore the relationship between preoperative and postoperative pain in patients with knee osteoarthritis (KOA) undergoing total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKR), and to assess the mediating roles of central and peripheral sensitization.</p> Methods <p>This prospective cohort study enrolled a total of 105 eligible KOA patients. The Visual Analog Scale (VAS) was used to assess preoperative and postoperative pain levels. Multivariate linear regression analysis and Bootstrap mediation analysis were conducted to investigate the impact of preoperative pain intensity on postoperative pain.</p> Results <p>This study revealed a significant positive correlation between preoperative VAS scores during movement and pain scores 3&#xa0;days postoperatively (β = 0.4018, <i>p</i> = 0.0017), as well as a significant correlation with pain scores 6&#xa0;months postoperatively (β = 0.735, <i>p</i> = 0.004). Central sensitization (β = 0.0446, <i>p</i> &lt; 0.0001) and peripheral sensitization (β = 0.0333, <i>p</i> = 0.0015) exhibited significant mediation effects between preoperative and postoperative pain. Additionally, preoperative VAS scores (B = 1.107, <i>p</i> = 0.014, OR = 3.027), age (B = 0.207, <i>p</i> = 0.036, OR = 1.229), and duration of arthritis (B = 0.190, <i>p</i> = 0.013, OR = 1.210) were significant predictors of postoperative analgesic demand.</p> Conclusion <p>This study demonstrates that preoperative pain intensity is closely related to postoperative pain in KOA patients undergoing TKA and UKR, with central and peripheral sensitization playing significant mediating roles in this process. In particular, preoperative pain management is crucial for alleviating postoperative pain and improving patients' quality of life. Therefore, when formulating individualized pain management strategies, the central and peripheral sensitivity of patients should be comprehensively considered. Future research is necessary to develop and evaluate innovative pain control methods integrating central and peripheral mechanisms to optimize postoperative rehabilitation and long-term health outcomes.</p>

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Mediating role of pain sensitization in preoperative and postoperative pain in knee osteoarthritis patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月17日

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  • Tianjiao Shen,
  • Ji Yuan,
  • Di Wang,
  • Xiaoqing Chai,
  • Hai Gu,
  • Lingsuo Kong,
  • Yinghong Wang

摘要

Objective

This study aims to explore the relationship between preoperative and postoperative pain in patients with knee osteoarthritis (KOA) undergoing total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKR), and to assess the mediating roles of central and peripheral sensitization.

Methods

This prospective cohort study enrolled a total of 105 eligible KOA patients. The Visual Analog Scale (VAS) was used to assess preoperative and postoperative pain levels. Multivariate linear regression analysis and Bootstrap mediation analysis were conducted to investigate the impact of preoperative pain intensity on postoperative pain.

Results

This study revealed a significant positive correlation between preoperative VAS scores during movement and pain scores 3 days postoperatively (β = 0.4018, p = 0.0017), as well as a significant correlation with pain scores 6 months postoperatively (β = 0.735, p = 0.004). Central sensitization (β = 0.0446, p < 0.0001) and peripheral sensitization (β = 0.0333, p = 0.0015) exhibited significant mediation effects between preoperative and postoperative pain. Additionally, preoperative VAS scores (B = 1.107, p = 0.014, OR = 3.027), age (B = 0.207, p = 0.036, OR = 1.229), and duration of arthritis (B = 0.190, p = 0.013, OR = 1.210) were significant predictors of postoperative analgesic demand.

Conclusion

This study demonstrates that preoperative pain intensity is closely related to postoperative pain in KOA patients undergoing TKA and UKR, with central and peripheral sensitization playing significant mediating roles in this process. In particular, preoperative pain management is crucial for alleviating postoperative pain and improving patients' quality of life. Therefore, when formulating individualized pain management strategies, the central and peripheral sensitivity of patients should be comprehensively considered. Future research is necessary to develop and evaluate innovative pain control methods integrating central and peripheral mechanisms to optimize postoperative rehabilitation and long-term health outcomes.