Gender and preoperative pain characteristics influence the efficacy of pain neuroscience education (PNE) in knee osteoarthritis people scheduled for total knee arthroplasty (TKA).

This secondary analysis was carried out to examine the effect of gender and baseline pain characteristics on efficacy of preoperative PNE + knee joint mobilization vs. biomedical education + knee joint mobilization in knee osteoarthritis people who were scheduled to undergo TKA.

A total of 44 subjects suffering from knee osteoarthritis were divided randomly into two groups, the PNE + knee joint mobilization and biomedical education + knee joint mobilization group following baseline evaluation of quantitative sensory testing and self-reported questionnaires (that included pain intensity, symptoms of central sensitization, disability and pain cognitions). One month after four sessions of treatment and at three months post-surgery, the questionnaires were taken again.

Utilizing cluster analysis and principal components assessment, the sample was subdivided into a high and low pain cluster on the basis of baseline quantitative sensory testing results. With the aid of a 3-way analysis of variance, with therapy, gender and baseline pain cluster as between factors, and with time as within factor, the evaluation of therapeutic effects over time was done.

Regarding self-reported symptoms of central sensitization, women were benefited more from PNE intervention when compared to the control intervention. The differences in therapeutic effects regarding pain intensity and pain cognitions were reported for both the pain clusters. A comparatively greater superiority of PNE intervention was noted in the high-pain cluster subgroup when compared to the low-pain cluster.

While executing PNE intervention in individuals scheduled to undergo TKA, the potential effect of gender and preoperative pain measures on the efficacy of PNE must be taken into consideration.