Knee and
hip osteoarthritis are highly prevalent in the older population. Management of
osteoarthritis-related
pain includes conservative or surgical treatment. Although knee or hip joint replacement is associated with positive outcomes, up to 30% of patients report
postoperative pain in the first two years. This study aimed to synthesize current evidence on prognostic factors for predicting
postoperative pain after knee or hip replacement. An umbrella review of systematic reviews was conducted to summarize the magnitude and quality of the evidence for prognostic preoperative factors predictive of postoperative
chronic pain (>6 months after surgery) in patients who had received knee or hip replacement. Searches were conducted in MEDLINE, CINAHL, PubMed, PEDro, SCOPUS, Cochrane Library, and Web of Science databases from inception up to 5 August 2022 for reviews published in the English language. A narrative synthesis, a risk of bias assessment, and an evaluation of the evidence confidence were performed. Eighteen reviews (nine on knee surgery, four on hip replacement, and seven on both hip/knee replacement) were included. From 44 potential preoperative prognostic factors, just 20 were judged as having high or moderate confidence for robust findings. Race,
opioid use, preoperative function,
neuropathic pain symptoms, pain catastrophizing, anxiety, other
pain sites,
fear of movement, social support, preoperative
pain, mental health, coping strategies, central sensitization-associated symptoms, and depression had high/moderate confidence for an association with postoperative
chronic pain. Some comorbidities such as
heart disease,
stroke,
lung disease,
nervous system disorders, and poor circulation had high/moderate confidence for no association with postoperative
chronic pain. This review has identified multiple preoperative factors (i.e., sociodemographic, clinical, psychological, cognitive) associated with postoperative
chronic pain after knee or hip replacement. These factors may be used for identifying individuals at a risk of developing postoperative
chronic pain. Further research can investigate the impact of using such prognostic data on treatment decisions and patient outcomes.