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Factors Associated With the Risk of Neuropathic Pain One Year After Total Knee Arthroplasty and the Protective Role of Local Infiltration Analgesia: A Registry‐Based Prospective Cohort Study
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Factors Associated With the Risk of Neuropathic Pain One Year After Total Knee Arthroplasty and the Protective Role of Local Infiltration Analgesia: A Registry‐Based Prospective Cohort Study
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Factors Associated With the Risk of Neuropathic Pain One Year After Total Knee Arthroplasty and the Protective Role of Local Infiltration Analgesia: A Registry‐Based Prospective Cohort Study
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Journal Article
Factors Associated With the Risk of Neuropathic Pain One Year After Total Knee Arthroplasty and the Protective Role of Local Infiltration Analgesia: A Registry‐Based Prospective Cohort Study
2025
Overview
Objective To identify predictors of reduced risk for neuropathic pain (NP) one year after total knee arthroplasty (TKA) among patients who did not report NP before surgery. Methods We included primary TKAs performed between January 1, 2014, and June 30, 2022. NP was defined as Douleur Neuropathique en 4 Questions scores ≥4 before and one year after TKA. We selected patients without NP before surgery and ran simple log‐binomial regressions and a multiple log‐binomial regression on the presence or absence of NP at one year after surgery. We included predictive variables associated with patient characteristics (sex, age at surgery, body mass index [BMI], smoking status, diabetes, medication, and short‐form 12‐question [SF‐12] mental scores) and operative variables (patella resurfacing, type of anesthesia, glucocorticoids, and local infiltration analgesia [LIA]). Results A total of 889 patients were included for initial analysis, with 636 included in the log‐binomial regression. The incidence of NP at one year among the latter was 8.6% (55 of 636). LIA had a strong protective effect with an adjusted risk ratio (RR) of 0.45 (95% confidence interval [CI] 0.26–0.77). LIA led to an NP risk reduction of 6.1% (95% CI 1.4–10.7; 12.2% of NP without infiltration and 6.1% with). The other protective factors identified were higher SF‐12 mental scores (adjusted RR 0.97; 95% CI 0.95–1.00), older age (adjusted RR per decade 0.78; 95% CI 0.59–1.03), and BMI <35 (adjusted RR 0.60; 95% CI 0.33–1.09). Conclusions Our study identified factors associated with reduced risk of NP one year after TKA among patients without preoperative NP. The use of LIA was newly identified as being associated with a lower likelihood of NP after surgery.
Publisher
Wiley Periodicals, Inc,John Wiley & Sons, Inc,Wiley
Subject
