Objective To explore the latent profiles and influencing factors of preoperative central sensitization in patients undergoing total knee arthroplasty （TAK）, so as to provide evidence for personalized management of central sensitization. Methods A conve-nience sample of 360 patients scheduled for TKA was recruited between April 2024 and March 2025.Data were collected using the Central Sensitization Inventory-9 (CSI-9), Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). Results Three distinct latent profiles of preoperative central sensitization were identified:high sensitization-generalized group (5.81%), moderate sensitization-pain amplification group (15.99%), and low sensitization-compensated group (78.20%).Gender, preoperative resting and movement pain intensity, duration of knee osteoarthritis, WOMAC score, pain catastrophizing, sleep quality, anxiety, and depression were significantly associated with profile membership （all P＜0.05）. Conclusion Preoperative central sensitization in patients undergoing TKA is generally at a low-to-moderate level but demonstrates significant heterogeneity.Healthcare professionals should implement tailored nursing interventions based on identified influencing factors to alleviate pain perception and improve clinical outcomes.