Low central sensitisation inventory score is associated with better post-operative outcomes of osteotomy around the knee

Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5896-5904. doi: 10.1007/s00167-023-07646-y. Epub 2023 Nov 14.

Abstract

Purpose: The purpose of this study was to investigate the potential association between central sensitisation inventory (CSI) scores and post-operative patient-reported outcomes (PROs) in patients underwent osteotomy around the knee (OAK), with a CSI cut-off score specific for knee osteoarthritis.

Methods: CSI scores were collected from 173 patients who underwent OAK, along with their knee injury and osteoarthritis outcome score (KOOS) and pain numeric rating scale (NRS) scores. Patients were divided into high-CSI score group and low-CSI score group with a cut-off score of 17. Multivariate linear regression was performed to test the association between CSI scores and post-operative outcomes. Pre-surgery KOOS and NRS scores and the rate of attainment of minimal clinically important difference (MCID) of KOOS scores was analysed as secondary outcomes.

Results: Low-CSI score group had significantly higher post-operative KOOS scores and lower pain NRS scores compared to the high-CSI score group (< p = 0.01) after adjusting for confounding factors. For pre-operative scores, only the KOOS-Symptom score was significantly different between the groups (64.7 ± 20.1 when CSI < 17 vs.55.1 ± 19.7 when CSI ≥ 17; p = 0.008). The low-CSI score group had significantly higher MCID achievement rates of KOOS-Pain, Symptom, and ADL than the high-CSI score group (86% vs. 68%; 74% vs. 55%; 86% vs. 67%, respectively; P < 0.05).

Conclusions: This study established an association between post-operative CSI scores ≥ 17 and poorer outcomes following OAK, highlighting the potential value of the CSI in identifying patients in need of more comprehensive peri-operative pain management.

Level of evidence: Level III. Retrospective comparative study.

Keywords: Central sensitisation inventory; Osteotomy around the knee; Pain; Patient-reported outcomes.

MeSH terms

  • Arthroplasty, Replacement, Knee* / adverse effects
  • Central Nervous System Sensitization
  • Humans
  • Knee Joint / surgery
  • Osteoarthritis, Knee* / etiology
  • Osteoarthritis, Knee* / surgery
  • Osteotomy
  • Pain / surgery
  • Patient Reported Outcome Measures
  • Retrospective Studies
  • Treatment Outcome