Influencing factors of chronic pain after total knee replacement in osteoarthritis patients: a nomogram prediction model.

OBJECTIVES

To analyze the factors influencing chronic pain in patients with knee osteoarthritis after total knee replacement surgery (TKRS) and to construct a nomogram risk prediction model, providing an economically effective screening method for clinical use.

METHODS

This retrospective study included 100 consecutive patients at the Jinan Central Hospital, with knee osteoarthritis who underwent TKRS from January 2023 to December 2023. Patients were divided into the observation group (n=55) and the control group (n=45) based on the presence of chronic pain. Logistic regression was performed to explore factors associated with chronic pain, including medical records, laboratory data, previous history, and independent clinical risk factors. The identified independent factors were then incorporated to construct a nomogram for chronic pain prediction.

RESULTS

Six variables were identified as independent predictors of chronic pain after TKRS: age, BMI, diabetes, severity of preoperative pain, severity of postoperative acute pain, and postoperative wound infection (P<0.05). The area under the curve (AUC) of this nomogram was 0.836 [95% confidence interval (CI): 0.615-0.884], demonstrating good calibration and clinical practicability.

CONCLUSION

Age, BMI, diabetes, severity of preoperative pain, severity of postoperative acute pain, and postoperative wound infection are risk factors for chronic pain after TKRS. The predictive nomogram developed in this study shows good prediction ability and accuracy for chronic pain in patients with knee osteoarthritis after surgery.