Moderating effects of preoperative knee pain and pain catastrophizing on the relation between Catechol-O-methyltransferase (COMT) rs4680 genotypes and chronic postsurgical pain in total knee arthroplasty patients
Authors' conclusion
This study illuminates the significant role of the COMT Val158Met rs4680 polymorphism in susceptibility to prolonged pain following TKA. It also elucidates how these genetic genotypes interplay with preoperative knee pain and pain catastrophizing.
Study context
- Population
- Patients undergoing primary unilateral TKA
- Participants
- 280 patients
- Exposure
- COMT rs4680 genotypes (GG, GA, AA) with preoperative knee pain and pain catastrophizing as moderators
- Outcome
- Chronic postsurgical pain (CPSP)
- Follow-up
- 3, 6, and 12 months post-TKA
Methodological detailsBinary logistic regressions and interaction models; telephone interviews at follow-up
- Binary logistic regressions and interaction models; telephone interviews at follow-up
Main finding
As reported in the abstract
Moderation of genotype–CPSP relation
- Moderation by preoperative knee pain at 3 months (T1), R2 change
- 0.026
- P for moderation by preoperative knee pain at T1
- p = 0.026
- Johnson-Neyman region of significance for preoperative knee pain at T1: above threshold 17.18 (p = 0.05)
- 26.4%
- Three-way interaction genotype × knee pain × pain catastrophizing at 12 months (T3), R2 change
- 0.051
- P for three-way interaction at T3
- p = 0.009
- GG: region of significance for pain catastrophizing above 32.74 at T3
- 30.5%
- GA: region of significance for pain catastrophizing above 22.38 at T3
- 50.8%
- AA: region of significance for pain catastrophizing below 11.94 at T3
- 63.2%
Observational data: associations, not effects.
Original publication
Moderating effects of preoperative knee pain and pain catastrophizing on the relation between COMT rs4680 genotypes and chronic postsurgical pain in total knee arthroplasty patients. Anaesth Crit Care Pain Med. Published 24 February 2024. doi:10.
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