Preoperative predictors of postoperative opioid usage, pain scores, and referral to a pain management service in total knee arthroplasty.
Academic Article
Overview
abstract
BACKGROUND: Little is known about preoperative predictors of postoperative pain and referral to a recuperative pain management service after total knee arthroplasty (TKA). QUESTIONS/PURPOSES: We sought to identify the preoperative predictors of postoperative pain scores, referral to a pain management service, and narcotic usage in patients undergoing primary total knee arthroplasty. METHODS: We performed a prospective cohort study of 97 TKAs from a single surgeon. Pre and 6-week postoperative WOMAC, visual analog pain scale (VAS) scores, narcotic usage, and catastrophizing pain scores were collected. RESULTS: After adjusting for all other variables, higher age and catastrophizing pain scores were associated with lower odds of postoperative opioid usage. Increasing age and BMI were associated with lower odds of being referred to pain management. There was no relationship between self-reported preoperative pain tolerance and postoperative change in WOMAC or VAS pain scores. CONCLUSIONS: This information may help surgeons advise their patients preoperatively and set expectations during the recovery period.
