Presurgical anxiety and acute postsurgical pain predict worse chronic pain profiles after total knee/hip arthroplasty

Introduction Total joint arthroplasties generally achieve good outcomes, but chronic pain and disability are a significant burden after these interventions. Acknowledging relevant risk factors can inform preventive strategies. This study aimed to identify chronic pain profiles 6 months after arthroplasty using the ICD-11 (International Classification of Diseases) classification and to find pre and postsurgical predictors of these profiles. Materials and methods Patients undergoing total knee/hip arthroplasty ( n = 209, female = 54.5%) were assessed before surgery, 48 h and 6 months postsurgery for sociodemographic, pain-related, disability and psychological characteristics. K-means-constrained cluster analysis identified chronic pain profiles based on 6-month pain intensity, pain interference and disability. Chi-square tests or one-way ANOVA explored between-cluster differences. Multinomial regression identified predictors of cluster membership. Separate models analyzed presurgical (model 1), postsurgical (model 2) and a combination of previously significant pre and postsurgical (model 3) variables. Results A three-cluster solution was selected, translating increasingly worse chronic pain severity: cluster 1 (C1, n = 129), cluster 2 (C2, n = 60) and cluster 3 (C3, n = 20). There were presurgical differences among clusters in the presence of other painful sites ( p = 0.013, ϕc = 0.20), pain interference ( p = 0.038, η 2 = 0.031), disability ( p = 0.020, η 2 = 0.037), pain catastrophizing ( p = 0.019, η 2 = 0.060), anxiety ( p