{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:26:54Z","timestamp":1791822414258,"version":"4.3.4"},"reference-count":58,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF21OC0065373"],"award-info":[{"award-number":["NNF21OC0065373"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001732","name":"Danmarks Grundforskningsfond","doi-asserted-by":"publisher","award":["DNRF121"],"award-info":[{"award-number":["DNRF121"]}],"id":[{"id":"10.13039\/501100001732","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A subset of osteoarthritis patients will experience chronic postoperative pain after total knee arthroplasty (TKA), but the source of pain is unclear. The aim of this exploratory study was to assess patients with and without postoperative pain after TKA using magnetic resonance imaging (MRI), quantitative sensory testing (QST), clinical assessment of pain and assessments of catastrophizing thoughts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010six patients completed the 6\u2010month postoperative assessment. MRI findings were scored according to the MRI Osteoarthritis Knee Score recommendation for Hoffa synovitis, effusion size and bone marrow lesions. QST included assessment of pressure pain thresholds (PPTs), temporal summation of pain (TSP) and conditioned pain modulation (CPM). Pain catastrophizing was assessed using the Pain Catastrophizing Scale (PCS). Clinical pain assessment was conducted using a visual analogue scale (VAS, 0\u201310\u00a0cm), and groups of moderate\u2010to\u2010severe (VAS\u2009&gt;\u20093) and none\u2010to\u2010mild postoperative pain (VAS\u2009\u2264\u20093) were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with moderate\u2010to\u2010severe postoperative pain (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u200915) demonstrated higher grades of Hoffa synovitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001) and effusion size (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001), lower PPTs (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.039), higher TSP (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.001) and lower CPM (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.014) when compared with patients with none\u2010to\u2010mild postoperative pain (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u200931). No significant difference was found in PCS scores between the two groups. Multiple linear regression models found synovitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.036), effusion size (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.003), TSP (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.013) and PCS (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001) as independent parameters contributing to the postoperative pain intensity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These exploratory findings could indicate that chronic postoperative pain after TKA is a combination of joint\u2010related synovitis and effusion, sensitization of central pain mechanisms and potentially pain catastrophizing thoughts, but larger studies are needed to confirm this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The end\u2010stage treatment of knee osteoarthritis is total knee arthroplasty. Some patients experience chronic postoperative pain after total knee arthroplasty, but the mechanism for chronic postoperative pain is widely unknown. The current study indicates that higher levels postoperative of synovitis and effusion, higher temporal summation of pain and higher pain catastrophizing scores could be associated with higher chronic postoperative pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.2018","type":"journal-article","created":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T05:53:53Z","timestamp":1660283633000},"page":"1979-1989","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Chronic postoperative pain after total knee arthroplasty: The potential contributions of synovitis, pain sensitization and pain catastrophizing\u2014An explorative study"],"prefix":"10.1002","volume":"26","author":[{"given":"Thomas","family":"Kurien","sequence":"first","affiliation":[{"name":"University of Nottingham Academic Orthopaedics, Trauma and Sports Medicine  Nottingham UK"},{"name":"Nottingham Elective Orthopaedic Service (NEOS) Nottingham University Hospitals NHS Trust  Nottingham UK"},{"name":"Pain Centre Versus Arthritis University of Nottingham  Nottingham UK"},{"name":"NIHR Nottingham Biomedical Research Centre University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Kerslake","sequence":"additional","affiliation":[{"name":"Pain Centre Versus Arthritis University of Nottingham  Nottingham UK"},{"name":"NIHR Nottingham Biomedical Research Centre University of Nottingham  Nottingham UK"},{"name":"Sir Peter Mansfield Imaging Centre University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Graven\u2010Nielsen","sequence":"additional","affiliation":[{"name":"Center for Neuroplasticity and Pain (CNAP), Faculty of Medicine Aalborg University  Aalborg 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