Improving Patient Outcomes Following Total Knee Arthroplasty: Identifying Rehabilitation Pathways Based on Modifiable Psychological Risk and Resilience Factors

Abstract

Improving Patient Outcomes Following TKA interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarized, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilization of multivariate prediction models to inform individually tailored interventions targeting a range of health conditions.

Resilience and pain catastrophizing among patients with total knee arthroplasty: a cohort study to examine psychological constructs as predictors of post-operative outcomes

“…Their opinions of recovery are likely based on previous adverse experiences, daily recovery progress, as well as traits that cumulatively guide the patient toward specific emotional and behavioral responses [ 17 , 38 ]. Some patients may embody a trait known as “committed action”, which prompts them to intentionally pursue physically and mentally challenging tasks [ 39 ]. A patient who believes they are resilient will likely have higher levels of self-efficacy and will be more determined to complete what they perceive to be difficult physical tasks following surgery [ 40 ].…”

“…Determining which factors significantly and consistently predict postoperative outcomes will allow clinicians to gain insights about their patients’ potential functional trajectory that may not have been considered previously. As suggested in recent literature, the broader understanding of the patient experience beyond negative psychosocial factors may hold the key to eliciting modifiable risk factors for patients undergoing TKA [ 39 ]. The current study is powerful because it highlights a rarely assessed concept that has potential for integration into future multimodal predictions tools for outcomes related to TKA [ 39 ].…”

“…As suggested in recent literature, the broader understanding of the patient experience beyond negative psychosocial factors may hold the key to eliciting modifiable risk factors for patients undergoing TKA [ 39 ]. The current study is powerful because it highlights a rarely assessed concept that has potential for integration into future multimodal predictions tools for outcomes related to TKA [ 39 ]. In addition to defining the mechanisms behind the relationships between resilience and function as presented above, additional research in this area can also expand on the role of new psychosocial variables in the context of patient satisfaction in an increasingly patient-centered and patient-evaluated health care system.…”

Human outgrowth knee fibroblasts from patients undergoing total knee arthroplasty exhibit a unique gene expression profile and undergo myofibroblastogenesis upon TGFβ1 stimulation

“…Total knee arthroplasty (TKA) is a reliable and definitive surgical procedure for osteoarthritis of the knee. 1 Despite the success of contemporary primary TKAs, acquired idiopathic stiffness is a postoperative complication that occurs in approximately 5% of patients receiving TKA. 2 Arthrofibrosis is characterized by excessive periarticular fibrotic tissue deposition resulting in severe limitations in joint range of motion with inability to perform activities of daily living.…”

“…Total knee arthroplasty (TKA) is a reliable and definitive surgical procedure for osteoarthritis of the knee 1 . Despite the success of contemporary primary TKAs, acquired idiopathic stiffness is a postoperative complication that occurs in approximately 5% of patients receiving TKA 2 .…”