As depicted from this prospective study, the patients with low pain threshold (low algometer scores) have greater analgesic requirements after operation, had lengthier time to accomplish optimum range of movements and independent ambulation . Therefore, a proactive method is crucial for superior pain relief and a congenial experience following surgery in these patients.

The possible link between preoperative pain sensitivity and postoperative pain alongwith analgesic requirements for patients undertaking primary total knee arthroplasty (TKA) has been determined in this prospective study.

The pain sensitivity of 178 patients (mean age 64.13 years; 69.1% females ) undergoing primary TKA was examined before the operation via a digital algometer. Patients described the VAS (visual analog scale) score at 3 occurrences of needle prick (phlebotomy, glucometer blood glucose, intradermal antibiotic test dose), through the range of movements and accomplished the DASS (Depression, Anxiety, Stress Scale) score. On day 0 to 4, the postoperative VAS score, analgesic prerequisite, and physiotherapy milestones were noted in all of these patients.

As found, women had lower mean algometry values (56.12 ± SD12.77) than the men (71.09 ± SD18.78) (p<0.001). An elevated DASS associated with lower algometry values (p<0.001). At day 0, i.e. at the day of the surgery, postoperative VAS score was 2.54 ± 0.59 which raised to 3.27 ± 0.69 on day 1 following mobilization (p<0.001) and decreased to 1.67 ± 0 .62 on day 4 as shown in the following figure:

A low algometer score was linked with higher postoperative VAS score (p<0.05), increased analgesic requirement, and opioid use, delay in achieving an ideal range of movements and independent ambulation (p<0.001).

Preoperative assessment of pain sensitivity foretells the postoperative analgesic requirements and recovery duration. Preoperative counselling should be done in patients with a less pain threshold and have a better titration of analgesics perioperatively and extended physiotherapy.