Unravelling the role of and the interrelation between somatosensory functioning and metabolic factors in chronic (postsurgical) osteoarthritis pain

Chronic musculoskeletal pain (CMP) and knee osteoarthritis (OA) are highly prevalent and expected to increase in the future. Knee OA is the most common degenerative joint disease globally, causing significant pain, functional limitations, and disability. The pathological mechanisms underlying knee OA are complex, involving mechanical, inflammatory, and metabolic factors. Treatment mainly focuses on symptom reduction and when conservative treatments have been unsuccessful, total knee arthroplasty (TKA) is recommended. Despite good outcomes for many patients, 10-34% of patients still experience chronic pain after surgery. Possibly contributing to this chronic (postoperative) pain are metabolic conditions such as obesity and diabetes, along with altered somatosensory functioning. These conditions are associated with low-grade inflammation and may be interrelated due to this mutual link. Therefore, the overall aim of this doctoral thesis was to unravel the role and interrelation of somatosensory functioning and metabolic factors in chronic (postsurgical) OA pain.