• Anthony Wright, Penny Moss, Karen Sloan, Richard J Beaver, Jarle B Pedersen, Gerard Vehof, Henrik Borge, Luca Maestroni, and Philip Cheong.
• School of Physiotherapy and Exercise Science, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
• Clin. Orthop. Relat. Res. 2015 Jan 1;473(1):246-54.

BackgroundUp to 15% of patients report at least moderate persistent pain after TKA. Such pain may be associated with the presence of widespread hyperalgesia and neuropathic-type pain.Questions/PurposesWe asked if there was a difference among patients who report moderate to severe pain or no pain at least 12 months after TKA regarding (1) pressure pain threshold, (2) thermal (cold/heat) pain and detection thresholds, and (3) self-reported neuropathic pain.Patients And MethodFifty-three volunteers were recruited from patients reporting no pain or moderate to severe pain, according to the Knee Society Score©. Differences between the moderate-to-severe and no-pain groups regarding pressure pain, heat and cold thresholds, and self-reported neuropathic-type pain were analyzed using independent t-tests.ResultsPatients in the moderate-to-severe pain group exhibited reduced pressure pain threshold in the knee with the TKA (p=0.025) and at the elbow (p=0.002). This group also showed greater pain sensitivity to cold at the knee (p=0.008) and elbow (p=0.010), and increased heat pain sensitivity at the elbow (p=0.032). Cold and heat detection thresholds were impaired in this group at the elbow (cold, p=0.034; heat, p=0.010), although only heat detection was impaired at the knee (p=0.009). The moderate-to-severe pain group also reported more neuropathic-type pain (p=0.001).ConclusionPersistent pain after TKA was associated with widespread pressure, cold hyperalgesia, and greater neuropathic-type pain.Level Of EvidenceLevel III, prognostic study.

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