The study purpose is to determine if giving pregabalin before and after total knee
arthroplasty (TKA) can improve pain and meaningful function after surgery in patients that
have central sensitization (CS).
Participants will be identified who are indicated for TKA. Interested patients will complete
a standard Knee Injury and Osteoarthritis Outcomes Score (KOOS), asked their pain score (on a
scale of 0 to 10), and complete the Central Sensitization Inventory (CSI). If they meet
inclusion criteria and agree to participate, they will complete the informed consent before
being randomized 1:1 to usual care (control group) or pregabalin (study group). The study
group participants will take pregabalin starting 7 days prior to surgery. They will also be
scheduled to have a pre-operative physical therapy (PT) appointment which will include tests
and measures standard to PT. Tests will include a Timed Up and Go Test (TUG), a Sit to Stand
5 Times Repeat Test (5TSTS) and Patient Specific Functional Scale (SFS) measures.
On the day of surgery participants will be asked about any adverse effects of study
medication and determine need to withdraw from study. The post-operative plan will be
reviewed, including dose of study medication. For the pregabalin group the doses will be
doubled for 7 days, then reduced for 7 days, then off. All participants will be given
standard peri-operative pain management for TKA . All participants will complete standard of
practice physical therapy.
After surgery (usually within 7 days) a physical therapist will perform standard
post-operative evaluation and treatment for all participants. This includes a re-evaluation
of the same pre-operative functional tests of TUG, 5TSTS and PSFS outcome measures. The study
pharmacist will also call the patient to determine if there are any medication-related
adverse effects and how much opioid medication the patient is taking at that time (morphine
milligram equivalents- MME/day on average).
At the 6 week post-operative visit all participants will again complete the KOOS survey,
report a pain score, complete the CSI survey and determine MME based on patient report of
quantity of opioid medication used. A physical therapist will complete the functional
assessment of the TUG, 5TSTS and PSFS outcome measures.