Social determinants associated to chronic pain after total knee arthroplasty

Aim of the study: Analyze the association between social health determinants (SHD) and chronic post-surgical pain (CPSP) after total knee arthroplasty (TKA). Method: A cross-sectional study was performed in 58 TKA patients. The subjects were classified in two groups: with (n = 22) or without (n = 36) CPSP. SHD considered were gender, age, educational level, economic income, and labour conditions. Results: Significant differences were found concerning educational level when comparing subjects with or without CPSP, with a low educational level of 22.4% and 19%, respectively. 15.5% of patients with persistent pain had a high educational level compared with 43.1% of the patients without persistent pain (p = 0.032). No significant differences were found for the other categories (p > 0.05). The odds ratio (95% confidence interval) was 3.28 (1.09–9.93) for lower educational level compared with high educational level. Discussion: CPSP must be considered a severe health problem. In addition to SDH, there are multiple factors associated with chronic pain after TKA that must be considered for an effective treatment. Conclusions: Patients with lower educational level showed a three-time higher association to develop CPSP. Considering SHD could be of relevance when elaborating new interventions or health strategies and more specialized counseling for patients with persistent pain after TKA.