Preoperative Central Sensitization Worsens Pain and Dissatisfaction Following Unicompartmental Knee Arthroplasty
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patient Selection
2.3. Assessment of Central Sensitization
2.4. Surgical Procedure and Postoperative Management
2.5. Outcome Measures
3. Statistical Analysis
4. Results
5. Discussion
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CS | Central Sensitization |
UKA | Unicompartmental Knee Arthroplasty |
TKA | Total Knee Arthroplasty |
CSI | Central Sensitization Inventory |
WOMAC | Western Ontario and McMaster Universities Osteoarthritis Index |
FJS | Forgotten Joint Score |
OA | Osteoarthritis |
CNS | Central Nervous System |
QST | Quantitative Sensory Testing |
MB | Mobile-Bearing |
PROMs | Patient-Reported Outcome Measures |
KSS | Knee Society Satisfaction |
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Variables | Non-CS Group (CSI < 40) (n = 95) | CS Group (CSI ≥ 40) (n = 26) | Cohen’s d Effect Size | p-Value |
---|---|---|---|---|
Demographics | ||||
Age (years) | 61.5 ± 5.9 | 60.2 ± 7.4 | 0.21 | 0.366 |
Gender (Female, %) | 84 (88.4%) | 24 (22.2%) | 0.732 | |
BMI (kg/m2) | 25.6 ± 3.0 | 26.7 ± 3.3 | −0.36 | 0.114 |
CSI score | 22.7 ± 9.8 | 45.2 ± 4.2 | −2.52 | <0.001 |
ASA grade | ||||
1 | 6 (6.3%) | 2 (7.7%) | 0.681 | |
2 | 89 (93.7%) | 24 (92.3%) | ||
Operation side (Right, %) | 41 (43.2) | 14 (53.8%) | 0.514 | |
Specific comorbidities | ||||
Hypertension | 29 (30.5%) | 7 (19.4%) | 0.812 | |
Diabetes | 16 (16.8%) | 3 (11.5%) | 0.762 | |
Cardiac disease | 12 (12.6%) | 4 (15.4%) | 0.746 | |
Cerebrovascular event | 5 (5.3%) | 0 (0%) | 0.584 | |
Kidney disease | 2 (2.1%) | 0 (0%) | 0.615 | |
Thyroid disease | 5 (5.3%) | 1 (3.8%) | 0.618 | |
Pulmonary disease | 10 (10.5%) | 1 (3.8%) | 0.453 | |
Liver disease | 3 (3.2%) | 0 (0%) | 0.481 | |
Preoperative FTA (°) | Valgus 5.5 ± 2.7 | Valgus 5.5 ± 3.2 | 0.0 | 0.970 |
Preoperative HKA (°) | Varus 0.6 ± 3.4 | Varus 1.2 ± 3.8 | −0.17 | 0.441 |
Postoperative FTA (°) | Valgus 1.8 ± 3.2 | Valgus 2.3 ± 2.6 | −0.16 | 0.454 |
Postoperative HKA (°) | Varus 4.7 ± 3.4 | Varus 4.4 ± 3.2 | 0.09 | 0.664 |
Preoperative FC | 3.4 ± 5.4 | 3.1 ± 5.3 | 0.06 | 0.774 |
Preoperative FF | 127.7 ± 11.7 | 126.2 ± 15.4 | 0.12 | 0.583 |
Postoperative FC | 0.3 ± 1.2 | 0.8 ± 2.7 | −0.31 | 0.209 |
Postoperative FF | 129.7 ± 3.8 | 129.0 ± 3.0 | 0.19 | 0.361 |
Variables | Non-CS Group (CSI < 40) (n = 95) | CS Group (CSI ≥ 40) (n = 26) | Cohen’s d Effect Size | p-Value |
---|---|---|---|---|
Preoperative | ||||
WOMAC Total | 54.4 ± 11.6 | 63.7 ± 12.0 | −0.80 | 0.001 |
WOMAC Pain | 14.5 ± 4.2 | 17.5 ± 4.1 | −0.72 | 0.001 |
WOMAC Stiffness | 4.4 ± 2.9 | 4.8 ± 2.0 | −0.15 | 0.509 |
WOMAC Function | 36.1 ± 9.6 | 41.8 ± 8.2 | −0.61 | 0.006 |
Postoperative | ||||
WOMAC Total | 12.8 ± 7.1 | 30.5 ± 12.0 | −2.11 | <0.001 |
WOMAC Pain | 1.8 ± 1.4 | 7.8 ± 4.1 | −2.67 | <0.001 |
WOMAC Stiffness | 1.2 ± 1.3 | 1.8 ± 1.7 | −0.43 | 0.030 |
WOMAC Function | 9.6 ± 5.4 | 20.8 ± 7.7 | −1.88 | <0.001 |
WOMAC Change | ||||
WOMAC Total | 41.6 ± 12.7 | 33.1 ± 16.7 | 0.62 | 0.006 |
WOMAC Pain | 12.7 ± 4.5 | 9.7 ± 5.6 | 0.63 | 0.005 |
WOMAC Stiffness | 3.2 ± 2.7 | 3.0 ± 2.2 | 0.08 | 0.632 |
WOMAC Function | 26.5 ± 10.3 | 21.0 ± 10.8 | 0.53 | 0.019 |
Variables | Non-CS Group (CSI < 40) (n = 95) | CS Group (CSI ≥ 40) (n = 26) | Cohen’s d Effect Size | p-Value |
---|---|---|---|---|
FJS conditions | 72.7 ± 12.1 | 64.4 ± 16.3 | 0.63 | 0.005 |
1. In bed at night | 1.1 ± 0.7 | 1.6 ± 0.9 | −0.67 | 0.004 |
2. When sitting on a chair for more than 1 h | 1.0 ± 0.8 | 1.5 ± 0.8 | −0.63 | 0.006 |
3. When walking for more than 15 min | 1.1 ± 0.8 | 1.5 ± 0.8 | −0.50 | 0.187 |
4. When taking a bath/shower | 1.2 ± 0.8 | 1.6 ± 1.1 | −0.46 | 0.054 |
5. When traveling in a car | 1.0 ± 0.7 | 1.2 ± 1.0 | −0.26 | 0.166 |
6. When climbing stairs | 1.1 ± 0.9 | 1.2 ± 1.0 | −0.11 | 0.576 |
7. When walking on uneven ground | 1.4 ± 0.9 | 1.5 ± 0.8 | −0.11 | 0.541 |
8. When standing up from a low-sitting position | 1.2 ± 0.8 | 1.6 ± 1.1 | −0.46 | 0.042 |
9. When standing for long periods of time | 0.8 ± 0.8 | 1.2 ± 1.0 | −0.47 | 0.051 |
10. When doing housework or gardening | 1.0 ± 0.8 | 1.5 ± 1.0 | −0.59 | 0.003 |
11. When taking a walk or hiking | 1.1 ± 0.9 | 1.5 ± 0.7 | −0.47 | 0.087 |
12. When doing a favorite sport | 0.9 ± 0.6 | 1.3 ± 0.8 | −0.62 | 0.007 |
Variables | Non-CS Group (CSI < 40) (n = 95) | CS Group (CSI ≥ 40) (n = 26) | Cohen’s d Effect Size | p-Value |
---|---|---|---|---|
Satisfaction score | ||||
Sitting | 7.2 ± 1.3 | 6.3 ± 1.9 | 0.62 | 0.004 |
Lying in bed | 7.3 ± 1.2 | 6.4 ± 1.7 | 0.68 | 0.002 |
Getting out of bed | 6.8 ± 1.5 | 5.8 ± 2.0 | 0.62 | 0.013 |
Light household duties | 6.2 ± 1.6 | 5.4 ± 1.8 | 0.49 | 0.027 |
Leisure recreational activities | 5.5 ± 1.8 | 3.5 ± 1.7 | 1.12 | <0.001 |
Total | 33.1 ± 6.1 | 25.5 ± 8.8 | 1.12 | <0.001 |
Proportion | ||||
Satisfied | 91 (95.8%) | 17 (65.4%) | <0.001 | |
Dissatisfied | 4 (4.2%) | 9 (34.6%) |
Preoperative Variables | Univariate Regression Coefficient | 95% CI | p-Value | Multivariate Regression Coefficient † | 95% CI | p-Value |
---|---|---|---|---|---|---|
Age | 1.008 | 0.945–1.075 | 0.816 | 0.982 | 0.912–1.057 | 0.620 |
Sex (male vs. female) | 1.282 | 0.330–4.981 | 0.720 | 0.989 | 0.212–4.626 | 0.989 |
BMI (kg/m2) | 0.955 | 0.840–1.086 | 0.483 | 0.976 | 0.842–1.131 | 0.747 |
Preoperative HKA (°) | 1.072 | 0.957–1.201 | 0.232 | 1.114 | 0.982–1.265 | 0.094 |
ASA grade (grade 2 vs. 1) | 1.134 | 0.217–5.922 | 0.881 | 1.308 | 0.201–8.532 | 0.779 |
Preoperative FC (°) | 1.016 | 0.939–1.099 | 0.691 | 1.018 | 0.921–1.126 | 0.722 |
Preoperative FF (°) | 0.998 | 0.966–1.031 | 0.905 | 0.997 | 0.958–1.039 | 0.899 |
Preoperative WOMAC total score | 0.977 | 0.944–1.012 | 0.192 | 0.999 | 0.960–1.039 | 0.960 |
CSI score (≥40) | 5.833 | 2.297–14.814 | <0.001 | 6.526 | 2.298–18.531 | <0.001 |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Kim, M.-S.; Choi, K.-Y.; In, Y. Preoperative Central Sensitization Worsens Pain and Dissatisfaction Following Unicompartmental Knee Arthroplasty. Medicina 2025, 61, 912. https://doi.org/10.3390/medicina61050912
Kim M-S, Choi K-Y, In Y. Preoperative Central Sensitization Worsens Pain and Dissatisfaction Following Unicompartmental Knee Arthroplasty. Medicina. 2025; 61(5):912. https://doi.org/10.3390/medicina61050912
Chicago/Turabian StyleKim, Man-Soo, Keun-Young Choi, and Yong In. 2025. "Preoperative Central Sensitization Worsens Pain and Dissatisfaction Following Unicompartmental Knee Arthroplasty" Medicina 61, no. 5: 912. https://doi.org/10.3390/medicina61050912
APA StyleKim, M.-S., Choi, K.-Y., & In, Y. (2025). Preoperative Central Sensitization Worsens Pain and Dissatisfaction Following Unicompartmental Knee Arthroplasty. Medicina, 61(5), 912. https://doi.org/10.3390/medicina61050912