Psychosocial predictors of outcomes up to one year following total knee arthroplasty

Abstract

BackgroundTotal knee arthroplasty (TKA) aims to relieve pain and improve physical functioning of the knee, however, some patients continue to experience pain and impaired function following TKA which cannot be explained by surgical and implant factors. Psychological factors may influence the outcomes of TKA. The aim of this prospective study was to examine the psychosocial factors that predicted pain, stiffness and physical functioning up to 1 year following TKA. Methods 102 patients completed pre-operative and 1-year questionnaires which assessed a wide range of psychosocial and sociodemographic factors prior to surgery. The Oxford Knee Score (OKS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain, Stiffness and Physical Functioning subscales were used as outcome measures. Pearson correlation analysis and multiple linear regression were conducted to examine relationships between predictor and outcome variables. ResultsRegression analysis showed that regarding variance in WOMAC outcome measures post TKA, our model predicted 31% for physical functioning, 25% for pain and 29% for stiffness 4 at 1 year. Regarding variance in OKS post TKA, the model predicted 36% at 1 year. Greater levels of depressive symptoms and neuroticism and worse pre-operative scores significantly predicted poorer outcomes. ConclusionThe findings indicate that pre-operative psychosocial factors are important in understanding outcomes of TKA. Psychosocial factors could be considered during pre-operative assessment and further research conducted on psychological interventions within this population to determine whether early and 1-year outcomes can be improved.

Factors Correlated With Physical Function 1 Year After Total Knee Arthroplasty in Patients With Knee Osteoarthritis

“…We excluded 6 studies from analysis. 42 , 43 , 44 , 45 , 46 , 47 owing to unsuccessful attempts to obtain missing data. Sedentary behavior, 40 lack of energy, 38 drowsiness, 38 sleeping difficulties, 38 bloating, 38 worrying, 38 and problems with sexuality were reported once 38 and were not included in the meta-analysis.…”

“…We excluded 6 studies from analysis. [42][43][44][45][46][47] owing to unsuccessful attempts to obtain missing data. Sedentary behavior, 40 lack of energy, 38 drowsiness, 38 sleeping difficulties, 38 [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] 17 Studies included for quantitative synthesis meta-analysis [22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38]41…”

“…The most common physical function measure was the Western Ontario and McMaster Universities Arthritis Index (WOMAC). We excluded 6 studies from analysis . owing to unsuccessful attempts to obtain missing data.…”

Pain, sensitization and physical performances in patients with chronic painful knee osteoarthritis or chronic pain following total knee arthroplasty: An explorative study

“…Both parameters are assumed to have an impact on the central processing of pain and, hence, the sensitization processes (Arendt‐Nielsen et al., 2015; Schug & Bruce, 2017). It has also been shown that psychological factors, such as pain catastrophizing, anxiety and depression can influence chronic pain in patients with knee OA or chronic pain after TKA (Belford et al., 2020; Helminen et al., 2020). In the present study focusing on physical performances and pain mechanisms, no psychological measurements were included, and therefore we cannot infer the potential influence of these parameters on the outcomes.…”

Predictive Models for Clinical Outcomes in Total Knee Arthroplasty: A Systematic Analysis

“…(2020) [ 41 ] Moderate Moderate Low Low Moderate Low Low Moderate Belford et al. (2020) [ 64 ] Moderate Moderate Moderate Low Moderate Moderate Moderate Moderate Pua et al. (2020) [ 26 ] Moderate Low Low Low Low Moderate Moderate Moderate Farooq et al.…”