DN4
‐Positive Neuropathic Pain Features in End‐Stage Knee Osteoarthritis Awaiting Arthroplasty: Prevalence and Relationship With Function and Quality‐of‐Life
Alan P. Mozella, Ana Carolina Leal, Rafael Erthal de Paula, Aline Cordeiro Fernandes Ladeira, Sandra Minamoto, Matheus Carvalho, Jordanna Franco Sucupira, Ricardo Kobayashi, Thiago Lemos ABSTRACT
Objectives
This cross‐sectional study investigated the occurrence of neuropathic pain features (NP) in individuals with end‐stage knee osteoarthritis (KOA) referred to total knee arthroplasty (TKA) and explored its association with functional and quality‐of‐life outcomes.
Methods
In 902 patients, NP was screened using the Douleur Neuropathique 4 (scores ≥ 4). Distribution of NP features (positive/negative) regarding sex were assessed with z ‐test for proportions. The influence of NP features on the outcomes (visual analog scale for pain, WOMAC, SF‐36) were tested with the Mann–Whitney U , followed by a multivariate logistic regression model to identify independent predictors of NP features, using 5% as statistical threshold.
Results
The cohort was 72.6% female, with a mean ± SD age of 70 ± 8 years. NP‐positive features prevalence was 28.6% (95% CI of 25.7%–31.6%), which was significantly higher in females (31.5%) than males (21.1%; p < 0.001). Patients with NP‐positive features reported worse scores across all measured domains: higher pain intensity (VAS; p < 0.001), worse knee‐related symptoms/function (WOMAC pain, function, and total scores; all p < 0.001), and lower quality‐of‐life in specific SF‐36 domains (general health, vitality, role‐emotional, mental health; all p < 0.01). The multivariate model confirmed that higher WOMAC total score and specific SF‐36 scores were independently associated with NP‐positive features.
Conclusions
NP features are prevalent in approximately one‐third of the patients with end‐stage KOA awaiting arthroplasty, particularly among females. Its presence is independently associated with poorer joint‐related function and reduced quality‐of‐life, suggesting the potential value of NP features assessment and management into pre‐ and postsurgical care.