2023 ISAKOS Biennial Congress ePoster
Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
Man-Soo Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Dongho Kwak, MD, Seoul KOREA, REPUBLIC OF
Sungcheol Yang, MD, Seoul KOREA, REPUBLIC OF
Hyukjin Jang, MD, Seoul KOREA, REPUBLIC OF
Ryu Kyoung Cho, MD, Seoul KOREA, REPUBLIC OF
Yong In, MD, PhD, Seoul KOREA, REPUBLIC OF
Seoul St. Mary's Hospital, Seoul, KOREA, REPUBLIC OF
FDA Status Cleared
Summary
In patients who underwent TKA with knee OA, CSI is most often used for the diagnosis of CS, and the QST and whole-body pain diagram are also used. CS is closely associated with more severe and persistent pain after TKA.
ePosters will be available shortly before Congress
Abstract
Introduction
Central sensitization (CS) has been extensively researched as a cause of persistent pain after total knee arthroplasty (TKA). This systematic review study sought to investigate the diagnosis of CS in patients who underwent TKA for knee osteoarthritis (OA) and the effect of CS on clinical outcomes after TKA.
Methods
Three comprehensive databases, including MEDLINE, EMBASE, and the Cochrane Library, were searched for studies that evaluated the outcomes of TKA in knee OA patients with CS. Data extraction, risk of bias assessment, and (where appropriate) meta-analysis were performed. The standardized mean difference (SMD) with a 95% confidence interval was used to assess the different scales of pain.
Results
A total of 8 studies were selected, including 2 retrospective studies and 5 prospective observational studies. One study used additional randomized controlled trial data. Five studies were finally included in the meta-analysis. All studies had a minimum follow-up period of 3 months. The Central Sensitization Inventory (CSI), whole-body pain diagram, and quantitative sensory testing (QST) were used for measuring CS. The pooled analysis showed that patients with CS had more severe postoperative pain after TKA (SMD, 0.65; 95% CI, 0.40–0.90; P < 0.01) with moderate heterogeneity (I2 = 60%).
Conclusion
In patients who underwent TKA with knee OA, CSI is most often used for the diagnosis of CS, and the QST and whole-body pain diagram are also used. CS is closely associated with more severe and persistent pain after TKA.