"Multidisciplinary Pain Management Needed Before Knee Degenerative Arthritis Surgery"

Gangnam Bedro Hospital Orthopedics Department Chief Jaejung Kim
'ICKKS 2023' Research Paper Presentation

A study has found that identifying central sensitization before surgery for knee osteoarthritis can effectively reduce postoperative pain.

The research team led by Dr. Kim Jae-jung, head of the Orthopedics Department at Gangnam Bedro Hospital, announced this research paper at the recently held 'ICKKS 2023 Korean Knee Society International Conference and the 41st Regular Academic Conference' on the 24th.

At the 'ICKKS 2023 Korean Knee Society International Conference and the 41st Regular Academic Conference,' Dr. Kim Jae-jung, an orthopedic surgeon at Gangnam Bedro Hospital, is presenting research findings.
[Photo by Gangnam Bedro Hospital]

The research team analyzed 121 patients who underwent medial open proximal tibial osteotomy from May 2015 to April 2019 over a two-year period, investigating the degree of central sensitization before and after surgery, knee condition, and pain scales. The study subjects were those who had normal knee function and radiological examination results without complications after medial open proximal tibial osteotomy. The team classified them into a central sensitization group (37 patients) and a non-sensitization group (84 patients), comparing pain scales and knee function scores for about two years before and after surgery.

Central sensitization is a phenomenon where the central nervous system exhibits hypersensitive responses to pain. Because the pain threshold is lowered, stimuli that are not painful may be perceived as pain, or mild pain may be felt more intensely. Even without genetic predisposition, the central nervous system can become sensitized solely due to prolonged knee pain caused by osteoarthritis. In fact, about 20-30% of patients awaiting knee surgery are reported to already have central nervous system sensitization.

Through this study, the research team confirmed that if central sensitization is identified before surgery, chronic pain occurring after surgery can be improved. The central sensitization group experienced higher frequency and intensity of pain and had poorer knee function scores compared to the non-sensitization group.

Dr. Kim Jae-jung explained, "We started this research because chronic pain caused by central sensitization appeared even though the surgical treatment for osteoarthritis thoroughly resolved the problematic factors." He added, "It is necessary to investigate the presence of central sensitization in patients before performing medial open proximal tibial osteotomy. For patients diagnosed with central sensitization, selective administration of central nervous system-acting drugs before surgery and active, multidisciplinary rehabilitation approaches after surgery are essential to prevent chronic pain."