PainDETECT as a Potential Tool for Personalized Medicine: Predicting Outcome One Year After Knee Arthroplasty.

OBJECTIVE: To investigate whether neuropathic-like pain, identified using the PainDETECT questionnaire, predicts postoperative symptoms, using data from 2 independent, prospective cohort studies. PATIENTS AND METHODS: Data were collected from patients undergoing primary knee arthroplasty for primary osteoarthritis recruited to the Evaluation of perioperative Pain in Osteoarthritis of the kNEe (EPIONE) Study n=120, from October 1, 2011, to May 30, 2014, and the Clinical Outcomes in Arthroplasty Study (COASt) n=404, from January 1, 2010, to December 31, 2018). The PainDETECT questionnaire score was used to divide patients into nociceptive (<13), unclear (13-18), and neuropathic pain (>18) groups preoperatively using validated cutoffs. As the neuropathic group also captures nociplastic pain, we used neuropathic-like to represent this combination. Surgical outcome was compared between groups using the Oxford Knee Score (OKS) and the presence of moderate to severe pain 12 months after arthroplasty. RESULTS: Total of 296 (56%) reported nociceptive, 144 (27%) unclear, and 84 (16%) neuropathic-like pain preoperatively. Patients in the neuropathic-like pain group had significantly worse OKS postoperatively, compared with the nociceptive group (34 [12] vs 40 [8], P