Multidimensional assessment of pain in elderly individuals undergoing total hip Arthroplasty: A systematic review

Abstract

Effective postoperative pain management in elderly patients undergoing total hip arthroplasty (THA) necessitates an in-depth, multidimensional assessment capturing the sensory, affective, cognitive, and functional aspects of pain. This systematic review synthesizes evidence from 45 studies published between 2015 and 2025, encompassing randomized controlled trials, cohort studies, psychometric validation investigations, and clinical intervention evaluations. Key assessment instruments including the Geriatric Pain Measure (GPM-24), McGill Pain Questionnaire (MPQ), and Brief Pain Inventory (BPI) demonstrate robust psychometric properties and clinical relevance in this population. Multidimensional pain scores correlate strongly with opioid consumption, rehabilitation progress, and cognitive outcomes. Furthermore, analgesic approaches such as nerve blocks and multimodal pharmacotherapy analyzed through these tools reveal improvements in pain control and faster functional recovery. Challenges remain with tool applicability in cognitively impaired patients, cross-cultural validation, and routine clinical integration. This review underscores multidimensional pain assessment as essential for individualized analgesic strategies, improving elderly patients' postoperative recovery, well-being, and quality of life.