Impact of Preoperative Neuropathic Pain on Postoperative Outcomes Following Total Knee Arthroplasty

Chang Xiaofeng; Xu Chao; Yao Shuxin; Ma Jianbing

Abstract：Objective To analyze the correlation between the preoperative PainDETECT Questionnaire(PDQ)and the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores in patients with knee osteoarthritis(KOA),and to investigate the impact of preoperative neuropathic pain on postoperative outcomes following total knee arthroplasty(TKA).Methods In this prospective study,data from 153 KOA patients who underwent TKA at the Red Cross Hospital of Xi'an Jiaotong University from January 2023 to December 2023 were analyzed.The cohort comprised 37 males and 116 females,aged between 47 and 81 years[mean age(64.5±7.0)years].Patients with a preoperative PDQ score≥ 19(n=21,13.7％)were classified into the neuropathic pain group,while those with a PDQ score＜19(n=132)were assigned to the non-neuropathic pain group.Preoperative and 1-year postoperative PDQ and WOMAC scores were compared between the two groups,and Pearson correlation analysis was performed.Results With a follow-up duration of at least 12 months postoperatively,only 11 patients(7.2％)had a PDQ score ≥ 19 at follow-up,representing a significant reduction compared to preoperative levels.At 1 year postoperatively,the improvement in the WOMAC total score was significantly lower in the neuropathic pain group(3.9±3.7)points compared to the non-neuropathic pain group(5.5±5.9)points(P＜0.05).Moreover,the preoperative PDQ score was positively correlated with the WOMAC pain and function subscale scores(0.6＜r≤0.8).Conclusion KOA patients exhibiting neuropathic pain demonstrate less pronounced pain relief and functional improvement following TKA compared to patients without neuropathic pain.The preoperative assessment of neuropathic pain using the PDQ may serve as a predictive tool for postoperative pain and functional outcomes.