scholarly journals Effectiveness and reporting standards of psychological interventions for improving short-term and long-term pain outcomes after total knee replacement: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e029742 ◽  
Author(s):  
Katie Whale ◽  
Vikki Wylde ◽  
Andrew Beswick ◽  
James Rathbone ◽  
Kavita Vedhara ◽  
...  

ObjectivesTo assess the effectiveness and reporting standards of psychological interventions for improving outcomes after total knee replacement (TKR).DesignMedline, Embase, and PsycINFO were searched from inception to up to 9 May 2019 with no language restrictions applied. Randomised controlled trials (RCTs) assessing the effectiveness of psychological interventions for short-term and long-term postoperative pain after TKR were included. Screening, data extraction, and assessment of methodological quality were performed in duplicate by two reviewers. The primary effectiveness outcome was postoperative pain severity and the primary harm outcome was serious adverse events. Secondary outcomes included function, quality of life, and psychological well-being. Reporting standards were assessed using the Template for Intervention Description and Replication (TIDieR) checklist for intervention reporting.Results12 RCTs were included, with a total of 1299 participants. Psychological interventions comprised music therapy (five studies), guided imagery and music (one study), hypnosis (one study), progressive muscle relaxation with biofeedback (one study), pain coping skills programme (one study), cognitive–behavioural therapy (two studies), and a postoperative management programme (one study). Due to the high heterogeneity of interventions and poor reporting of harms data, it was not possible to make any definitive statements about the overall effectiveness or safety of psychology interventions for pain outcomes after TKR.ConclusionFurther evidence about the effectiveness of psychological interventions for improving pain outcomes after TKR is needed. The reporting of harm outcomes and intervention fidelity is currently poor and could be improved. Future work exploring the impact of intervention timing on effectiveness and whether different psychological approaches are needed to address acute postoperative pain and chronic postoperative pain would be of benefit.PROSPERO registration numberCRD42018095100.

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rongguo Yu ◽  
Youguang Zhuo ◽  
Eryou Feng ◽  
Wulian Wang ◽  
Wentao Lin ◽  
...  

Abstract Background A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention. Methods A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software. Results Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability). Conclusions Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.


The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 329-331 ◽  
Author(s):  
David Yeoh ◽  
Nick Nicolaou ◽  
Richard Goddard ◽  
Henry Willmott ◽  
Kim Miles ◽  
...  

2008 ◽  
Vol 75 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Klemmens Trieb ◽  
Maximillian Schmid ◽  
Thomas Stulnig ◽  
Wolfgang Huber ◽  
Axel Wanivenhaus

2017 ◽  
Vol 34 (10) ◽  
pp. 665-672 ◽  
Author(s):  
Dario Bugada ◽  
Massimo Allegri ◽  
Marco Gemma ◽  
Andrea L. Ambrosoli ◽  
Giuseppe Gazzerro ◽  
...  

1997 ◽  
Vol 79 (4) ◽  
pp. 575-82 ◽  
Author(s):  
DAVID R. DIDUCH ◽  
JOHN N. INSALL ◽  
W. NORMAN SCOTT ◽  
GILES R. SCUDERI ◽  
DAVID FONT-RODRIGUEZ

2019 ◽  
Vol 33 (03) ◽  
pp. 242-246
Author(s):  
James W. Pritchett

AbstractThis study reviewed the early use of polyurethane for total knee resurfacing, the long-term results of polycarbonate urethane (PCU) for total knee replacement and conducted wear simulator testing of PCU. In 1959 and 1960, 10 patients underwent total articular polyurethane knee replacement (polyethylene was not available). The polyurethane was placed on the articular surface of the femur with metal surfaces on the tibia and patella. In 1996 and 1997, four patients received a newer PCU tibial insert in revision procedures; all had well-fixed prostheses, but no revision polyethylene implants were available. In addition, this study evaluated six new PCU tibial inserts in a 10-million cycle (Mc) wear simulator. All 10 of the early knees performed well clinically and 2 knees were functional for more than 30 years. Of the four more recent patients, all knees remain functional at more than 20 years' follow-up with no signs of wear or osteolysis. Wear simulator testing found mean material loss of 14.2 mg/Mc which equates to a volumetric wear of 11.9 mg/Mc, similar to the wear of conventional polyethylene. Polyurethane performs well as conventional polyethylene but not better than current cross-linked polyethylene tibial inserts. Its large wear particles (mean, 11 µm) and biocompatibility are less likely to cause an inflammatory response leading to pain and bone loss. Newer, superior polyurethanes can again be considered a candidate material for the tibial insert of a total knee replacement. A larger study may be able to validate polyurethane as an alternative material for joint replacement.


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