Summary

If medical comorbidity is not a matter, performing same-day bilateral TKA is more advantageous in postoperative pain control in CS patients.

Abstract

Introduction

The purpose of this study was to compare the early postoperative pain patterns in both knees after same-day and staggered bilateral total knee arthroplasty (TKA) in Central sensitization (CS) patients.

Methods

Thirty-six patients in each group corresponding to CS were compared. For staggered bilateral TKA, only those with a one-week interval were included. CS was assessed using a Central Sensitization Inventory preoperatively. Postoperative pain was investigated 1st, 3rd, 5th, and 7th postoperative day using pain visual analogue scale (VAS) in resting, walking, night, and 24 hours average. The amounts of patient-controlled analgesia (PCA) were also investigated. The first and second knees in staggered bilateral TKA were compared with the knee on the first and second operating side in simultaneous bilateral TKA.

Results

There was no significant difference in pain VAS between the first knee of staggered TKA and the knee of the same surgical site in same-day TKA (all p>0.05). However, all pain VAS scores were higher in the second knee of the staggered TKA compared to the same side in same-day TKA (all p<0.05). The amount of PCA usage was also significantly more in 2nd knee of staggered bilateral TKA patients even compared to patients with simultaneous TKA. (p<0.05).

Conclusion

When staggered bilateral TKA was performed in CS patients, early postoperative pain in the 2nd knee was more severe than the pain amount of the same side knee in same-day bilateral TKA. If medical comorbidity is not a matter, performing same-day bilateral TKA is more advantageous in postoperative pain control in CS patients.