Early spatial pain contraction and moderate-to-severe knee pain 12 months after total knee arthroplasty: a retrospective cohort study
- 1Department Joint Surgery, Zhumadian Central Hospital, Zhumadian, China
Abstract
Background: While total knee arthroplasty (TKA) generally provides excellent pain relief, a substantial minority of patients develop persistent postsurgical pain. This study investigated whether the early postoperative contraction rate of whole-body spatial pain extent was associated with moderate-to-severe knee pain 12 months after TKA.
Methods: In this retrospective cohort study of patients undergoing primary unilateral TKA, participants completed whole-body pain drawings at 2 weeks, 6 weeks, and 3 months postoperatively. The Pain Extent Index (PEI) was calculated using a semiautomated image-processing workflow. The primary exposure was the patient-specific rate of PEI change between week 2 and month 3, determined via linear mixed-effects modeling. The primary outcome was moderate-to-severe operated-knee pain at 12 months. Logistic regression evaluated this association, adjusting for baseline covariates and static pain measures.
Results: At 12 months, 92 patients (14.7%) reported moderate-to-severe knee pain. Slower spatial pain contraction was significantly associated with higher odds of 12-month pain (adjusted odds ratio per 1-SD slower contraction, 1.42; 95% CI, 1.03–1.95). This association remained significant even after adjusting for baseline risk factors and static pain intensity and extent at both week 2 and month 3. Slower contraction was also correlated with poorer 12-month joint-related functional outcomes, including lower KOOS-JR scores (P < 0.001).
Conclusion: Slower contraction of spatial pain extent during the subacute recovery phase was associated with moderate-to-severe knee pain and inferior functional outcomes 1 year after TKA.
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BibTeX
@article{liu2026early,
title = {{Early spatial pain contraction and moderate-to-severe knee pain 12 months after total knee arthroplasty: a retrospective cohort study}},
author = {Jun Liu and Wenheng Chen and Shan Gao},
journal = {Frontiers in Pain Research},
year = {2026},
month = oct,
doi = {10.3389/fpain.2026.1948322},
url = {https://doi.org/10.3389/fpain.2026.1948322},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Early spatial pain contraction and moderate-to-severe knee pain 12 months after total knee arthroplasty: a retrospective cohort study
AU - Jun Liu
AU - Wenheng Chen
AU - Shan Gao
PY - 2026
DA - 2026/10/12
JO - Frontiers in Pain Research
DO - 10.3389/fpain.2026.1948322
UR - https://doi.org/10.3389/fpain.2026.1948322
AB - Background: While total knee arthroplasty (TKA) generally provides excellent pain relief, a substantial minority of patients develop persistent postsurgical pain. This study investigated whether the early postoperative contraction rate of whole-body spatial pain extent was associated with moderate-to-severe knee pain 12 months after TKA. Methods: In this retrospective cohort study of patients undergoing primary unilateral TKA, participants completed whole-body pain drawings at 2 weeks, 6 weeks, and 3 months postoperatively. The Pain Extent Index (PEI) was calculated using a semiautomated image-processing workflow. The primary exposure was the patient-specific rate of PEI change between week 2 and month 3, determined via linear mixed-effects modeling. The primary outcome was moderate-to-severe operated-knee pain at 12 months. Logistic regression evaluated this association, adjusting for baseline covariates and static pain measures. Results: At 12 months, 92 patients (14.7%) reported moderate-to-severe knee pain. Slower spatial pain contraction was significantly associated with higher odds of 12-month pain (adjusted odds ratio per 1-SD slower contraction, 1.42; 95% CI, 1.03–1.95). This association remained significant even after adjusting for baseline risk factors and static pain intensity and extent at both week 2 and month 3. Slower contraction was also correlated with poorer 12-month joint-related functional outcomes, including lower KOOS-JR scores (P < 0.001). Conclusion: Slower contraction of spatial pain extent during the subacute recovery phase was associated with moderate-to-severe knee pain and inferior functional outcomes 1 year after TKA.
SN - 2673-561X
ER -