The validation and cross-cultural adaptation of the PainDETECT questionnaire in osteoarthritis-related pain

Background Patients with knee osteoarthritis (KOA) often experience persistent pain and functional impairment after total knee arthroplasty (TKA), which presents challenges for pain management. Accurate preoperative assessment of pain characteristics is crucial for tailoring individualized treatment plans. The PainDETECT Questionnaire has been widely used to identify neuropathic components in chronic pain and has been validated for its reliability and validity across various cultural contexts. However, a culturally adapted version tailored to Chinese patients is currently lacking. This study aims to translate and culturally adapt PainDETECT for Chinese patients and evaluate its validity in TKA patients in China. Methods This study followed international guidelines to translate and adapt the PainDETECT Questionnaire (PDQ) into Chinese (PDQ-CV). A cohort of 241 knee osteoarthritis (KOA) patients completed the PDQ-CV, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol-5 Dimensions-5 Levels (EQ-5D-5 L), and Central Sensitization Inventory Chinese Version (CSI-CV). We assessed internal consistency using Cronbach's alpha and test-retest reliability via intraclass correlation coefficient (ICC). Construct and structural validity were evaluated through Pearson correlations and factor analyses. Results The PDQ-CV demonstrated good acceptability among KOA patients, with no floor or ceiling effects observed. Internal consistency was high (Cronbach's alpha = 0.896), and test-retest reliability was excellent (ICC = 0.994; 95% CI: 0.943-1.045). The PDQ-CV total score showed significant positive correlations with WOMAC (r = 0.589, P < 0.01), EQ-5D-5 L (r = 0.533, P < 0.01), and CSI-CV (r = 0.776, P < 0.01). Exploratory factor analysis (EFA) extracted two primary factors, corresponding to the sensory dimension (52.1% variance) and the affective dimension (16.3% variance), explaining a total variance of 68.4%. Conclusion The PDQ-CV demonstrated good feasibility, reliability, and validity in Chinese KOA patients, supporting its use in clinical practice and providing a foundation for future research.