Chronic Pain Profile After Total Knee Arthroplasty: A Prospective Cohort Study.

Abstract

Purpose: This study aimed to evaluate the progression of pain after total knee arthroplasty (TKA), to examine temporal changes in the sensory and affective components of pain, and to identify factors predicting chronic pain.

Design: A prospective cohort study.

Methods: This prospective study included 62 patients who underwent TKA between May 2023 and May 2024. Data were collected using a Patient Information Form, the McGill Short Form Pain Scale (SF-MPQ), and the Visual Analog Scale (VAS). Pain assessments were performed every 4 hours during the first 72 hours postoperatively, and at 3 and 6 months. Data were analyzed using descriptive statistics, paired-sample t-test, marginal homogeneity test, and multiple linear regression analysis.

Results: Pain scores were highest in the early postoperative period and decreased significantly at 3 and 6 months. The SF-MPQ sensory score decreased from 4.87 ± 3.32 at 3 months to 3.34 ± 2.20 at 6 months, and the total score decreased from 7.86 ± 5.50 to 5.40 ± 4.13 (p < .001). The VAS score also decreased from 1.77 ± 1.06 to 1.31 ± 0.82 (p = .001). A history of previous severe pain, previous surgical experience, and sensory and affective pain scores at 72 hours postoperatively were found to be significant predictors of pain level at 6 months.

Conclusions: Postoperative pain management should not focus solely on the early period. Higher pain intensity and higher sensory and emotional pain scores in the early postoperative period were associated with higher pain levels in the following months. Systematic monitoring by nurses using multidimensional scales such as the SF-MPQ can contribute to the prevention of chronic pain.

Clinical implications: Systematic monitoring by nurses using multidimensional scales such as the SF-MPQ can contribute to the prevention of chronic pain.