Abstract

Objective: This study aimed to determine the incidence of chronic postsurgical pain (CPSP) and identify potential risk factors for CPSP in orthopaedic surgery and its subspecialties.
Method: A retrospective cross-sectional study was employed at King Abdullah Medical City, Makkah, screening 1200 patients who underwent orthopaedic surgeries from January 2017 to April 2024. Data were collected from the hospital record system, targeting patients whose pain persisted for more than three months following surgery and fit the definition of CPSP criteria, leading to 86 identified patients after exclusions. Data-like demographic characteristics, surgical variables, and clinical pain characteristics were collected.
Results: The overall incidence of CPSP in orthopaedic surgery was 7.2%. Regarding the incidence rates for specific subspecialties, majority were of shoulder (2.60%). The mean age was 55.8 ± 14 years, of whom 62.8% were female. Most cases had a high educational level (72%). Medical comorbidities, particularly diabetes mellitus (46.5%), were significantly high among the CPSP cases. Multiple linear regression analysis for the factors associated with CPSP revealed that age was significantly associated with CPSP with unadjusted and adjusted models at p-values of 0.043 and 0.035, respectively. Operative time duration and smoking were significantly associated with prolonged pain (p-values = 0.045 and 0.03).
Conclusion: CPSP remains a significant issue in orthopaedic surgery, particularly among older-age females. Medical comorbidity, smoking, and prolonged duration of surgery were associated with the incidence of chronic post-surgical pain. These findings highlighted the need for preoperative assessments and targeted interventions to reduce the incidence of CPSP and improve postoperative outcomes.

Key words: Incidence, chronic post-surgical pain, orthopedic surgery, potential risk factors, Saudi Arabia