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This study aims to examine the prevalence of CS, its associated factors, and short-term postoperative outcomes in high-altitude TKA patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This prospective, single-centre cohort study included high-altitude (above 2,500\u00a0m) TKA patients with primary knee osteoarthritis (OA). Central sensitization (CS) was diagnosed using the Central Sensitization Inventory (CSI), with a cutoff score of \u2265\u200940. Propensity score matching (PSM) was applied to balance baseline characteristics between the CS and non-CS groups. Preoperative factors, postoperative outcomes (pain levels, complications, opioid consumption, hospital stay), and the incidence of chronic pain and dissatisfaction at six months were collected and analyzed using SPSS software.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 230 patients were included, with 36 (15.7%) classified as having CS. Multivariable logistic regression identified female gender (OR: 3.9, 95% CI: 1.0\u201314.3, <jats:italic>P<\/jats:italic>\u2009=\u20090.043), higher body mass index (BMI) (OR: 1.2, 95% CI: 1.1\u20131.3, <jats:italic>P<\/jats:italic>\u2009=\u20090.006), and residence above 4,000\u00a0m (OR: 5.1, 95% CI: 1.7\u201315.1, <jats:italic>P<\/jats:italic>\u2009=\u20090.003) as significant factors associated with CS. After PSM, the CS group had significantly worse short-term outcomes, with higher pain scores at 24, 48, and 72\u00a0h (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), increased incidence of postoperative nausea and vomiting (PONV) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), longer hospital stays (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), greater cumulative opioid consumption (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), higher rates of chronic postoperative pain (46.9% vs. 21.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.014), and greater patient dissatisfaction (25.0% vs. 6.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.039) compared to the non-CS group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study found a 15.7% prevalence of CS among high-altitude TKA patients. Female gender, higher BMI, and residence at altitudes above 4,000\u00a0m were identified as factors associated with CS. Furthermore, CS was linked to worse short-term postoperative outcomes, including higher pain levels, increased incidence of PONV, greater opioid consumption, longer hospital stays, and a higher prevalence of chronic postoperative pain and dissatisfaction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00264-025-06560-x","type":"journal-article","created":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T02:29:20Z","timestamp":1749263360000},"page":"1887-1894","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence, associated factors, and short-term impact of central sensitization in high-altitude patients undergoing total knee arthroplasty"],"prefix":"10.1007","volume":"49","author":[{"given":"Siqing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linmei","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kefu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,7]]},"reference":[{"key":"6560_CR1","doi-asserted-by":"publisher","first-page":"3854","DOI":"10.1016\/j.arth.2017.07.021","volume":"32","author":"R Gunaratne","year":"2017","unstructured":"Gunaratne R, Pratt DN, Banda J, Fick DP, Khan RJK, Robertson BW (2017) Patient dissatisfaction following total knee arthroplasty: a systematic review of the literature. 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