The Impact of Gender, Age, and Preoperative Pain Severity on Pain After TKA

Do gender and age affect knee arthroplasty outcomes? In a cohort of patients who underwent primary or revision TKA between 1996 and 2004 and responded to a followup questionnaire 2 and 5 years after arthroplasty, we investigated the impact of gender and age on the prevalence of moderate or severe post-TKA knee pain (primary TKA: 2 years, 5290; 5 years, 2602; revision TKA: 2 years, 1109; 5 years, 505). Moderate-severe pain was higher in women than men after primary TKA at 2 and 5 years (9% versus 6.6% and 7.9% versus 6.5%) and post-revision TKA at 2 and 5 years (28.6% versus 22% and 28.9% versus 18.3%). More women compared to men and fewer patients between 61 and 70 years (versus patients ≤ 60) had moderate-severe pain 2 years after primary TKA adjusting for gender, age, and preoperative pain severity. In the post-revision TKA group, the odds of moderate-severe pain were lower in patients older than 80 years (versus those ≤ 60) at 2 years and higher in patients with moderate-severe preoperative pain at 2 and 5 years postoperatively, after adjustment for gender, age, and preoperative pain severity. We conclude female gender, younger age, and worse preoperative pain predict greater risk of moderate-severe pain postoperatively in patients with primary and revision TKA.

Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.