Getachew M, Lerdal A, Småstuen MC, et al. - Studies have described a possibility for an increase in patients’ experience of pain prior to surgery in correlation with co-occurring symptoms, however, there is no study reporting the correlations between preoperative pain, fatigue, sleep problems, depression and postoperative pain after TKA. Hence researchers herein tested their hypothesis that the co-occurrence of high symptom levels prior to surgery is linked with higher risk of pain 12 months post TKA. In a longitudinal cohort study, patients undergoing primary TKA (n = 202) were recruited and completed questionnaires measuring demographics and symptoms (pain, fatigue, sleep problems and depression) preoperatively. Reassessment of pain was done 12 months after TKA. Moderate-severe pain after TKA was described by more than one-third (40%) of patients (n = 187). Per findings, a key risk factor for moderate-severe pain 12 months after TKA was the combination of high fatigue and pain scores prior to surgery. They suggest preoperative mapping of these factors as possibly valuable for identifying patients who are at risk to experience a poor outcome of TKA.