{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T19:10:25Z","timestamp":1774120225411,"version":"3.50.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pain control following knee arthroplasty is extremely important to both patients and surgeons to improve the perioperative experience; however, the implication of early pain control on long-term outcomes following knee arthroplasty remains poorly understood. We hypothesized that poor early pain control results in poor functional outcomes 2 years following total (TKA) and unicondylar knee arthroplasty (UKA). This retrospective study reviewed 242 TKA and 162 UKA performed at a single institution by two surgeons. Mean visual analog scale (VAS) pain scores were collected for first 3 postoperative days. Patients were prospectively evaluated using short form (SF-12), the Western Ontario and McMaster University osteoarthritis index (WOMAC), and the Knee Society functional score (KSFS) questionnaires. Pearson's correlation coefficients were calculated between mean VAS pain scores and functional outcome scores at 2 years. In the TKA group, poorly controlled perioperative pain correlated with poorer functional scores at 2 years. There was a significant negative correlation between early mean VAS pain scores (mean, 3.2\u2009\u00b1\u20092.0) and most 2-year functional outcomes including SF-12 physical score (r\u2009=\u2009\u22120.227, p \u2264 0.01), WOMAC pain scores (r\u2009=\u2009\u22120.268, p \u2264 0.01), WOMAC stiffness scores (r\u2009=\u2009\u22120.224, p\u2009&lt;\u20090.01), WOMAC function score (r\u2009=\u2009\u22120.290, p 0.01), and KSFS (r\u2009=\u2009\u22120.175, p\u2009=\u20090.031). Better control of early pain was associated with improved functional outcomes at 2 years following TKA. We also found significant negative correlations between preoperative functional scores and early postoperative pain scores. Collectively, using preoperative and early postoperative pain scores, we identified an \u201cat-risk\u201d patient group that manifested an inferior functional outcome at 2 years; these patients may benefit from closer surveillance and a multidisciplinary approach to pain and function to optimize their clinical outcome following knee arthroplasty.<\/jats:p>","DOI":"10.1055\/s-0039-1692650","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T22:47:52Z","timestamp":1562194072000},"page":"1132-1139","source":"Crossref","is-referenced-by-count":25,"title":["Early Postoperative Pain Predicts 2-Year Functional Outcomes following Knee Arthroplasty"],"prefix":"10.1055","volume":"33","author":[{"given":"Akshay","family":"Lakra","sequence":"additional","affiliation":[{"name":"Center for Hip and Knee Replacement, Department of Orthopedic Surgery, New York Presbyterian Hospital\/Columbia University Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Murtaugh","sequence":"additional","affiliation":[{"name":"Center for Hip and Knee Replacement, Department of Orthopedic Surgery, New York Presbyterian Hospital\/Columbia University Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshan P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Center for Hip and Knee Replacement, Department of Orthopedic Surgery, New York Presbyterian Hospital\/Columbia University Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. John","family":"Cooper","sequence":"additional","affiliation":[{"name":"Center for Hip and Knee Replacement, Department of Orthopedic Surgery, New York Presbyterian Hospital\/Columbia University Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Geller","sequence":"additional","affiliation":[{"name":"Center for Hip and Knee Replacement, Department of Orthopedic Surgery, New York Presbyterian Hospital\/Columbia University Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"issue":"461","key":"ref1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/BLO.0b013e31804ea0bc","article-title":"Functional disabilities and issues of concern in female Asian patients before TKA","volume":"461","author":"K K Park","year":"2007","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/S0025-6196(11)63995-5","article-title":"Patients' concerns prior to undergoing total hip and total knee arthroplasty","volume":"74","author":"R T Trousdale","year":"1999","journal-title":"Mayo Clin Proc"},{"issue":"S 02","key":"ref3","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.arth.2006.04.017","article-title":"The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty","volume":"21","author":"C L Peters","year":"2006","journal-title":"J Arthroplasty"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3928\/01477447-20100722-65","article-title":"Pain management in total joint arthroplasty: a historical review","volume":"33","author":"T T Horlocker","year":"2010","journal-title":"Orthopedics"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/j.arth.2013.03.008","article-title":"Efficacy of multimodal perioperative analgesia protocol with periarticular medication injection in total knee arthroplasty: a randomized, double-blinded study","volume":"28","author":"T C Kelley","year":"2013","journal-title":"J Arthroplasty"},{"issue":"07","key":"ref6","first-page":"17","article-title":"Preventive analgesia for postoperative pain control: a broader concept","volume":"7","author":"N Vadivelu","year":"2014","journal-title":"Local Reg Anesth"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s40265-015-0365-2","article-title":"Preventive analgesia and novel strategies for the prevention of chronic post-surgical pain","volume":"75","author":"H Clarke","year":"2015","journal-title":"Drugs"},{"issue":"03","key":"ref8","first-page":"1","article-title":"Neuroendocrine and immune responses to surgery","volume":"30","author":"R Scholl","year":"2012","journal-title":"Internet J Anesth"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1054\/jpai.2002.123652","article-title":"Adverse events associated with postoperative opioid analgesia: a systematic review","volume":"3","author":"M Wheeler","year":"2002","journal-title":"J Pain"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/bja\/87.1.36","article-title":"Safety and efficacy of patient-controlled analgesia","volume":"87","author":"P E Macintyre","year":"2001","journal-title":"Br J Anaesth"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1097\/ALN.0000000000002132","article-title":"Association of multimodular pain management strategies with perioperative outcomes and resource utilization: a population-based study","volume":"128","author":"S G Memtsoudis","year":"2018","journal-title":"Anesthesiology"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1302\/0301-620X.94B11.29165","article-title":"Pain management protocols, peri-operative pain and patient satisfaction after total knee replacement: a multicentre study","volume":"94","author":"C B Chang","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"S 03","key":"ref13","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.arth.2007.05.040","article-title":"Pain management and accelerated rehabilitation for total hip and total knee arthroplasty","volume":"22","author":"A S Ranawat","year":"2007","journal-title":"J Arthroplasty"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"963","DOI":"10.2106\/00004623-200405000-00012","article-title":"Health-related quality of life in total hip and total knee arthroplasty. 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