Preoperative pain catastrophizing affects pain outcome after total knee arthroplasty

2021 ◽  
Author(s):  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Yohei Naito ◽  
Akihiro Sudo
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Pain Catastrophizing ◽  
Preoperative Pain ◽  
Pain Outcome ◽  
Total Knee

Does Preoperative Pain Catastrophizing Influence Objectively Measured Physical Activity Before and After Total Knee Arthroplasty: A Prospective Cohort Study

2020 ◽  
pp. 1-7
Author(s):  
Sara Birch ◽  
Torben Bæk Hansen ◽  
Maiken Stilling ◽  
Inger Mechlenburg
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Muscle Mass ◽  
Knee Arthroplasty ◽  
Pain Catastrophizing ◽  
Knee Function ◽  
Preoperative Pain ◽  
Before And After ◽  
Total Knee

Background: Pain catastrophizing is associated with pain both before and after a total knee arthroplasty (TKA). However, it remains uncertain whether pain catastrophizing affects physical activity (PA). The aim was to examine the influence of pain catastrophizing on the PA profile, knee function, and muscle mass before and after a TKA. Methods: The authors included 58 patients with knee osteoarthritis scheduled for TKA. Twenty-nine patients had a score >22 on the Pain Catastrophizing Scale (PCS), and 29 patients had a score <11. PA was measured with a triaxial accelerometer preoperative, 3 months, and 12 months after TKA. Other outcome measures consisted of the Knee Osteoarthritis Outcome Score and dual-energy X-ray absorptiometry scans. Results: The authors found no difference in PA between patients with a better/low or a worse/high score on the PCS, and none of the groups increased their mean number of steps/day from preoperative to 12 months postoperative. Patients with better/low PCS scores had higher/better preoperative scores on the Knee Osteoarthritis Outcome Score subscales (symptoms, pain, and activity of daily living), and they walked longer in the 6-min walk test. Further, they had lower body mass index, lower percent fat mass, and higher percent muscle mass than patients with worse/high PCS scores both before and after a TKA. Conclusion: Preoperative pain catastrophizing did not influence PA before or after a TKA. Although the patients improved substantially in self-reported knee function, their PA did not increase. This may be important to consider when the clinicians are informing the patients about the expected benefits from the operation.

scholarly journals Association of preoperative pain in knee and external to knee with postoperative pain outcome after total knee arthroplasty

2019 ◽  
Vol 14 (4) ◽  
pp. 480-488
Author(s):  
Tak Kyu Oh ◽  
Chong Bum Chang ◽  
Hyun-Jung Shin ◽  
Sunghee Han ◽  
Sang-Hwan Do ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Preoperative Pain ◽  
Pain Outcome ◽  
Total Knee

Acute postoperative pain is an independent predictor of chronic postsurgical pain following total knee arthroplasty at 6 months: a prospective cohort study

2019 ◽  
Vol 44 (3) ◽  
pp. e100036 ◽  
Author(s):  
Asokumar Buvanendran ◽  
Craig J Della Valle ◽  
Jeffrey S Kroin ◽  
Mahendra Shah ◽  
Mario Moric ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Risk Factor ◽  
Knee Arthroplasty ◽  
Pain Catastrophizing ◽  
Primary Source ◽  
Operative Management ◽  
Preoperative Pain ◽  
Postsurgical Pain ◽  
Chronic Postsurgical Pain ◽  
Total Knee

BackgroundApproximately 15% of patients report persistent knee pain despite surgical success following total knee arthroplasty (TKA). The purpose of this study was to determine the association of acute-postsurgical pain (APSP) with chronic postsurgical pain (CPSP) 6 months after TKA controlling for patient, surgical and psychological confounding factors.MethodsAdult patients with osteoarthritis undergoing primary elective tricompartmental TKA, with the operated knee the primary source of preoperative pain, were studied between March 2011 and February 2017. Patients received standard operative management and a perioperative multimodal analgesia regimen. The primary outcome was CPSP at 6 months. The primary variable of interest was the APSP (weighted mean pain score) for 72 hours postoperatively. Patient, surgical and psychological confounders were assessed using binary logistic regression.Results245 cases were analyzed. The incidence of CPSP was 14% (95% CI 10% to 19%). Median APSP values were 4.2 (2.2–5.0) in the CPSP group and 2.8 (1.8–3.7) without CPSP, difference 1.4 (95% CI 0.1 to 1.8, p=0.005). The unadjusted odds for CPSP with an increase of 1 in APSP was 1.46 (95% CI 1.14 to 1.87, p=0.002)). After multivariable risk adjustment, the OR for CPSP for an increase of 1 in the APSP was 1.53 (95% CI 1.12 to 2.09, p=0.008).ConclusionsAPSP is a risk factor for CPSP following TKA even after adjusting for confounding variables such as pain catastrophizing, anxiety, depression and functional status. Studies are needed to determine if APSP is a modifiable risk factor for the development of CPSP.

scholarly journals Preoperative Determinants of Patient-reported Pain and Physical Function Levels Following Total Knee Arthroplasty: A Systematic Review

2016 ◽  
Vol 10 (1) ◽  
pp. 213-231 ◽  
Author(s):  
E. Lungu ◽  
P-A. Vendittoli ◽  
F. Desmeules
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Methodological Quality ◽  
Pain Catastrophizing ◽  
Current Status ◽  
Medium Term ◽  
Preoperative Pain ◽  
Specific Patient ◽  
Patient Reported ◽  
Total Knee

Background:A sound knowledge of the determinants of total knee arthroplasty (TKA) outcomes could help in patient selection, preparation and education. We aimed to assess the current status of the literature evaluating preoperative determinants of early and medium term patient-reported pain and disability following TKA.Method:A search in Medline, Pubmed, Embase and CINAHL until October 2014 was undertaken. Selection criteria included: 1- participants undergoing primary unilateral TKA with a follow-up from 6 months to 2 years, 2- validated disease-specific patient-reported outcome measures assessing pain and/or function used as outcome measure and 3- identification of preoperative determinants obtainedviamultivariate analyses. Risk of bias was assessed using a modified version of the Methodology checklist for prognostic studies.Results:Thirty-three prognostic explanatory studies were included. Mean total score of the methodological quality was 80.7±12.2 %. Sociodemographic and psychosocial determinants included greater socioeconomic deprivation (both studies), greater levels of depression and/or anxiety (7 out of 10 studies) and greater preoperative pain catastrophizing (all 3 studies). Significant clinical determinants included worse pre-operative knee related pain or disability (20 out of 22 studies), presence or greater levels of comorbidity (12 out of 23 studies), back pain (4 out of 5 studies) and lower general health (all 11 studies).Conclusion:Several significant determinants of short to medium-term pain and functional outcomes following TKA have been summarized by studies with moderate-to-high methodological quality. No conclusions can be reached regarding the strength of the associations between significant determinants and TKA results because of heterogeneity of study methodologies and results. Further high-quality research is required.

scholarly journals Temporal association of pain catastrophizing and pain severity across the perioperative period: a cross-lagged panel analyses following total knee arthroplasty

Pain Medicine ◽  
2021 ◽  
Author(s):  
Traci J Speed ◽  
Chung Jung Mun ◽  
Michael T Smith ◽  
Harpal S Khanuja ◽  
Robert S Sterling ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Structural Equation ◽  
Pain Catastrophizing ◽  
Perioperative Period ◽  
Pain Severity ◽  
Equation Modeling ◽  
Temporal Association ◽  
Preoperative Pain ◽  
Total Knee

Abstract Objective While numerous studies show that preoperative pain catastrophizing is a risk factor for pain following total knee arthroplasty (TKA), little is known regarding the temporal course of the association between perioperative pain catastrophizing and pain severity. The present study investigated temporal changes and their dynamic associations between pain catastrophizing and pain severity before and after TKA. Design A secondary data analysis of a larger observational parent study featuring prospective repeated measurement over 12 months. Setting Dual-site academic hospital. Subjects 245 individuals who underwent TKA. Methods Participants completed pain catastrophizing and pain severity questionnaires at baseline, 6-weeks, and 3-, 6-, and 12-months post-TKA. Cross-lagged panel analysis was conducted using structural equation modeling including age, sex, race, baseline anxiety and depressive symptoms as covariates. Results Reduction in pain catastrophizing from baseline to 6-week post-TKA was associated with lower pain severity at 3-month post-TKA (standardized β = .14; SE = .07, p = .046), while reduction in pain severity at 6-week post-TKA was not associated with pain catastrophizing at 3-month post-TKA (p = .905). In the chronic post-surgical period (&gt;3 months), pain catastrophizing at 6-month post-TKA predicted pain severity at 12 months post-TKA (β = .23, p = .009)] while controlling for auto-correlation and covariates, but not vice versa. Conclusions We provide evidence that changes in pain catastrophizing from baseline to 6-week post-TKA are associated with subsequent pain severity. Future studies are warranted to determine whether targeting pain catastrophizing during the perioperative period may improve clinical outcomes for individuals undergoing TKA.

scholarly journals The influence of pre- and perioperative administration of gabapentin on pain 3–4 years after total knee arthroplasty

2018 ◽  
Vol 18 (2) ◽  
pp. 237-245 ◽  
Author(s):  
Kristian Kjær Petersen ◽  
Troels Haxholdt Lunn ◽  
Henrik Husted ◽  
Lars Tambour Hansen ◽  
Ole Simonsen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Pain Catastrophizing ◽  
Depression Scale ◽  
Psychological State ◽  
Chronic Postoperative Pain ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Total Knee

AbstractBackground and aims:Approximately 20% of patients having total knee arthroplasty (TKA) will experience chronic postoperative pain. Recently, preoperative pain facilitation has been associated with chronic pain after TKA, and gabapentin has been shown to decrease pain facilitation. The current study is a secondary follow-up of a primary RCT investigating the effect of gabapentin on acute postoperative pain after TKA and exploring the effect of pre- and perioperative administration of gabapentin on chronic postoperative pain and psychological state 3–4 years after TKA.Methods:Patients scheduled for TKA were randomized to either gabapentin 1,300 mg/day, gabapentin 900 mg/day, or placebo daily from 2-h before and 6 days after operation. Pre- and 3–4 years postoperatively pain scores related to pain while walking, at rest, when flexing the hip or the knee were collected. At the same time, the pain catastrophizing scale (PCS) and hospital anxiety and depression scale subscales for anxiety (HADS-A) and depression (HADS-D) were collected.Results:Lower postoperative pain while walking, flexing the hip, and at rest were found compared with preoperative scores (p<0.03), but these were not associated with gabapentin treatment (p>0.19). Significantly lower postoperative PCS and HADS-A scores were seen compared with preoperative scores (p<0.001), but these were not associated with gabapentin treatment (p>0.55).Conclusions:The current study found that pre- and perioperative administrations of gabapentin do not influence the pain or psychological state 3–4 years after TKA.Implications:The current study does not support that short-term pre- and perioperative use of gabapentin can reduce the development of chronic postoperative pain after TKA.

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