Prevalence and predictors of chronic post-surgical pain one year after total knee and hip arthroplasty

Total knee and hip arthroplasties (TKA/THA) are effective interventions to improve pain and disability due to severe osteoarthritis.However, some patients do not recover as expected and may develop chronic post-surgical pain (CPSP).Identifying pre-/post-surgical risk factors is relevant to inform preventive strategies.This study aimed to identify the prevalence and predictors of CPSP at 12 months after TKA and THA.It was a prospective observational study with patients undergoing TKA (n = 127) or THA (n = 113) evaluated before surgery, and at 48 h, 3, 6, and 12 months after surgery.Assessments included demographic, clinical, pain-related, disability, health-related quality-of-life, and psychological variables.Predictors of CPSP at 12 months (pain numerical rating scale > 3) were analyzed in three separate multinomial logistic regression models, including baseline and 48h variables that distinguished between groups (no/mild, moderate, and severe pain).The prevalence of CPSP was 30.4% 12 months after TKA/THA, with the final regression model identifying female sex (odds ratio [OR] = 3.307, p = 0.046), longer pre-surgical pain duration (OR = 1.005, p = 0.048), higher pre-surgical anxiety (OR = 1.125, p = 0.021), and more intense acute post-surgical pain (APSP) (OR = 1.358, p = 0.014) as significant predictors of severe CPSP, in comparison with no/mild pain.A relevant proportion of patients (30.4%) developed CPSP after TKA and THA.Sex, pre-surgical pain duration, pre-surgical anxiety, and APSP emerged as predictors of CPSP.Interventions targeted at these relevant risk factors may be promising to prevent pain chronification.