Journal Article

Risk factors of chronic postoperative pain after total knee arthroplasty: a systematic review

Zhai, Yue, Guan, Tingyu, Li, Junfei, Zhang, Yuxia

2024

Overview

Background There is a lack of relevant studies to grade the evidence on the risk factors of chronic pain after total knee arthroplasty (TKA), and only quantitative methods are used for systematic evaluation. The review aimed to systematically identify risk factors of chronic postoperative pain following TKA and to evaluate the strength of the evidence underlying these correlations. Methods PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched from initiation to September 2023. Cohort studies, case-control studies, and cross-sectional studies involving patients undergoing total knee replacement were included. A semi-quantitative approach was used to grade the strength of the evidence-based on the number of investigations, the quality of the studies, and the consistency of the associations reported by the studies. Results Thirty-two articles involving 18,792 patients were included in the final systematic review. Ten variables were found to be strongly associated with postoperative pain, including Age, body mass index (BMI), comorbidities condition, preoperative pain, chronic widespread pain, preoperative adverse health beliefs, preoperative sleep disorders, central sensitization, preoperative anxiety, and preoperative function. Sixteen factors were identified as inconclusive evidence. Conclusions This systematic review clarifies which risk factors could be involved in future research on TKA pain management for surgeons and patients. It highlights those factors that have been controversial or weakly correlated, emphasizing the need for further high-quality studies to validate them. Most crucially, it can furnish clinicians with vital information regarding high-risk patients and their clinical attributes, thereby aiding in the development of preventive strategies to mitigate postoperative pain following TKA. Trial registration This systematic review has been registered on the PROSPERO platform (CRD42023444097).

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Age Factors / Aged / Anxiety - etiology / Arthroplasty, replacement, knee / Arthroplasty, Replacement, Knee - adverse effects / Body Mass Index / Care and treatment / Chronic pain / Chronic Pain - epidemiology / Chronic Pain - etiology / Comorbidity / Female / Humans / Male / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Orthopedics / Pain / Pain, Postoperative / Pain, Postoperative - etiology / Risk factor / Risk Factors / Sleep disorders / Sleep Wake Disorders - epidemiology / Sleep Wake Disorders - etiology / Surgical Orthopedics / Systematic Review