Psychological determinants of problematic outcomes following Total Knee Arthroplasty

Sullivan, Michael; Tänzer, Michael; Stanish, William D.; Fallaha, Michel; Keefe, Francis J.; Simmonds, Maureen J.; Dunbar, Michael J.

doi:10.1016/j.pain.2009.02.011

Cited by 281 publications

(247 citation statements)

References 64 publications

Supporting

Mentioning

203

Contrasting

Unclassified

Order By: Relevance

“…We found that preoperative depressive symptoms trajectories were not prognostic for the postoperative pain trajectories. Other reports found depressive symptoms to be prognostic for postoperative pain [5,6,12,17], but others did not [4,21,25]. We also found that patient depressive symptom scores did not improve after surgery.…”

Section: Discussionsupporting

confidence: 45%

“…In addition, depressive symptoms have been shown to decrease after surgery [5,6,12]. However, other studies have suggested depressive symptoms have little influence on pain or function postoperatively [21,25]. Our study was hypothesis-driven because several studies have reported inconsistent findings related to the prognostic value of preoperative depressive symptoms and the extent to which depressive symptoms change from the pre-to the postoperative period [5,6,12,16,17].…”

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

What Is the Relationship Between Depressive Symptoms and Pain During Functional Tasks in Persons Undergoing TKA? A 6-year Perioperative Cohort Study

Riddle

Perera

Nay

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Preoperative depressive symptoms have been shown in some but not all studies to be associated with poor self-reported pain and function outcomes. In addition, depressive symptoms after surgery have been shown to improve relative to preoperative levels.Questions/purposes We hypothesized that (1) preoperative depressive symptoms would predict postoperative pain; (2) depressive symptoms would decrease after surgery; and (3) preoperative depressive symptoms would increase as the scheduled surgery date approached. Methods Data from the Osteoarthritis Initiative, a National Institutes of Health-funded prospective multiyear cohort study, were used in this retrospective analysis. Persons from four communities were eligible if they had radiographic knee osteoarthritis or were at risk for developing knee osteoarthritis based on occupational, medical history, or body weight risk factors. A total of 4796 persons participated and rates of followup were 80% or greater over the course of the study. Participants completed a validated depressive symptom scale and the Knee Injury and Osteoarthritis Outcome Scale pain scale each year for 3 years before and 3 years after TKA. Latent growth curve modeling was used to model intercepts and slopes of preand postoperative depression and pain. Preoperative trajectories and intercepts were then used to predict postoperative pain and depressive symptoms adjusting for confounding variables. Results After adjustment for potential confounding, we found no evidence that preoperative depressive symptoms predicted postoperative pain with function (estimate, 0.1; 95% confidence interval, À0.31 to 0.50; p = 0.64) or that depressive symptoms were reduced after surgery Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. The Osteoarthritis Initiative (OAI) is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262), funded by the National Institutes of Health (NIH), a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation; GlaxoSmithKline; and Pfizer, Inc. Private-sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public-use data set and does not necessarily reflect the opinions or views of the OAI Investigators, the NIH, or the private funding partners. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that...

show abstract

Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 86%

What Is the Relationship Between Depressive Symptoms and Pain During Functional Tasks in Persons Undergoing TKA? A 6-year Perioperative Cohort Study

Riddle

Perera

Nay

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Studies have shown that pain catastrophizing, greater medical comorbidity, lower educational attainment, depression, fear avoidance, and other psychologic factors are associated with persistent pain and/ or enhanced functional limitations after TKA [9,10,17,26,29,35]. Pain catastrophizing has been defined as ''an exaggerated negative mental set brought to bear during actual or anticipated painful experience'' [31].…”

Section: Introductionmentioning

confidence: 99%

“…Pain catastrophizing has been defined as ''an exaggerated negative mental set brought to bear during actual or anticipated painful experience'' [31]. Prior research on factors associated with persistent OA-related knee pain (lasting more than 6 months) found that pain catastrophizing explained a substantial proportion of variance in measures of pain, psychologic disability, and limitations in walking speed [27,29,30]. Similarly, worse mental health (including depression) and greater number of pain problems have been associated with worse THA and TKA outcomes [22,29,36].…”

Section: Introductionmentioning

confidence: 99%

“…Prior research on factors associated with persistent OA-related knee pain (lasting more than 6 months) found that pain catastrophizing explained a substantial proportion of variance in measures of pain, psychologic disability, and limitations in walking speed [27,29,30]. Similarly, worse mental health (including depression) and greater number of pain problems have been associated with worse THA and TKA outcomes [22,29,36]. Given the large number of TKAs performed, poor symptomatic outcomes constitute a prevalent and expensive health problem in the United States [1,7,11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Dave

Selzer

Losina

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Greater levels of self-reported pain, pain catastrophizing, and depression have been shown to be associated with persistent pain and functional limitation after surgeries such as TKA. It would be useful for clinicians to be able to measure these factors efficiently. Questions/purposes We asked: (1) What is the association of whole-body pain with osteoarthritis (OA)-related knee pain, function, pain catastrophizing, and mental health? (2) What is the sensitivity and specificity for different cutoffs for body pain diagram region categories in relation to pain catastrophizing? Methods Patients (n = 267) with knee OA undergoing elective TKA at one academic center and two community orthopaedic centers were enrolled before surgery in a prospective cohort study. Questionnaires included the WOMAC Pain and Function Scales, Pain Catastrophizing Scale (PCS), Mental Health Inventory-5 (MHI-5), and a pain body diagram. The diagram documents pain in 19 anatomic areas. Based on the distribution of the anatomic areas, we established six different body regions. Our analyses excluded the index (surgically treated) knee. Linear regression was used to evaluate the association between the total number of nonindex painful sites on the whole-body pain diagram and measures of OA-related pain and function, mental health, and pain catastrophizing. Generalized linear regression was used to evaluate the association between the number of painful nonindex body regions (categorized as 0; 1-2; or 3-6) with our measures of interest. All models were adjusted for age, sex, and number of comorbid conditions. The cohort included 63% females and the mean age was 66 years (SD, 9 years). With removal of the index knee, the median pain diagram score was 2 (25 th , 75 th percentiles, 1, 4) with a range of 0 to 15. The median number of painful body regions was 2 (25 th , 75 th percentiles, 1, 3). Results After adjusting for age, sex, and number of comorbid conditions, we found modest associations between painful body region categories and mean scores for WOMAC physical function (r = 0.22, p \ 0.001), WOMAC pain (r = 0.20, p = 0.001), MHI-5 (r = À0.31, p\ 0.001), and PCS (r = 0.27, p \ 0.001). A nonindex body pain region score greater than 0 had 100% (95% CI, 75%-100%) sensitivity for a pain catastrophizing score greater than 30 but a specificity of just 23% (95% CI, 18%-29%) . A score of 3 or greater had greater specificity (73%; 95% CI, 66%-79%) but lower sensitivity (53%; 95% CI, 27%-78%). Conclusions We found modest associations between the number of painful sites on a whole-body pain diagram and the number of painful body regions and measures of OArelated pain, function, pain catastrophizing, and mental health. Patients with higher self-reported body pain region scores might benefit from further evaluation for depression and pain catastrophizing. Level of Evidence Level III, therapeutic study.

show abstract

Pain catastrophizing and fear of movement: detection and intervention

Paré

Sullivan

2022

Clinical Pain Management

View full text Add to dashboard Cite

Psychological determinants of problematic outcomes following Total Knee Arthroplasty

Cited by 281 publications

References 64 publications

What Is the Relationship Between Depressive Symptoms and Pain During Functional Tasks in Persons Undergoing TKA? A 6-year Perioperative Cohort Study

What Is the Relationship Between Depressive Symptoms and Pain During Functional Tasks in Persons Undergoing TKA? A 6-year Perioperative Cohort Study

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Pain catastrophizing and fear of movement: detection and intervention

Contact Info

Product

Resources

About