Resilience as a Predictor of Patient Satisfaction With Nonopioid Pain Management and Patient-Reported Outcome Measures After Knee Arthroscopy

Chavez, Tyler J.; Garvey, Kirsten D.; Collins, Jamie E.; Lowenstein, Natalie A.; Matzkin, Elizabeth G.

doi:10.1016/j.arthro.2020.03.013

Cited by 21 publications

(33 citation statements)

References 17 publications

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“…On the other hand, our findings seem to agree with those from another study [ 28 ], which measured the relationship between postoperative outcomes and preoperative BRS in arthroscopy patients. Both studies found that BRS does not correlate with postoperative satisfaction and functional outcomes.…”

Section: Discussionsupporting

confidence: 92%

Patient Resilience Has Moderate Correlation With Functional Outcomes, but Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty

et al. 2021

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Background: As many as 20% of patients who undergo total knee arthroplasty (TKA) are dissatisfied. Psychological factors have been shown to play a role in outcomes after TKA. The purpose of this study was to investigate the impact of patient resilience on functional outcomes and satisfaction after primary unilateral TKA. Methods: Eighty-six patients who underwent primary unilateral TKA by a single surgeon were studied. Primary outcomes were the Brief Resilience Scale (BRS), mental health component of the Veterans Rand 12-Item Health Survey (VR-12 MCS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and New Knee Society Score. Correlations between BRS and dependent variables were found by using Spearmen's Rho Correlation testing. Unadjusted and adjusted regressions were run using the delta values as the dependent outcome and the BRS score as the main independent value, with data presented as an estimate of 95% confidence interval P value. Results: Resilience significantly correlated with male sex (P ¼ .031), preoperative VR-12 MCS scores (P ¼ .013), and postoperative VR-12 MCS scores (P < .001). BRS had moderate correlation with postoperative Knee Society Scores (KSS) Functional Activity Scores, as this approached, but did not achieve statistical significance (P ¼ .062). There was no correlation between BRS and postoperative KSS Patient Expectations score, KSS Patient Satisfaction score, or total postoperative opioid usage. Conclusions: Primary TKA patients with greater resilience are more likely to be male and have better mental health characteristics than those with lower resilience. Patients with greater resilience also tended to have improved knee function after TKA, although this was not statistically significant. Resiliency did not correlate with postoperative opioid consumption or patient satisfaction after TKA.

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Section: Discussionsupporting

confidence: 92%

Patient Resilience Has Moderate Correlation With Functional Outcomes, but Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty

et al. 2021

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“…found that highly resilient patients demonstrated no difference in knee functional scores from low- or normally resilient patients after arthroscopic knee surgery. 29 The relationship between resilience and outcomes from arthroscopic surgery may not be comparable to the arthroplasty literature and merits further investigation.…”

Section: Discussionmentioning

confidence: 99%

Impact of patient resilience on early recovery from rotator cuff repair

et al. 2021

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Aims We sought to evaluate early recovery from rotator cuff repair by assessing the correlation between patient resilience and postoperative shoulder pain and function, and physical and mental health. Methods Patients scheduled to undergo arthroscopic rotator cuff repair were prospectively enrolled. Resilience was assessed using the Brief Resilience Scale (BRS), pain and function was measured by American Society of Shoulder and Elbow Surgeons (ASES) shoulder scores, and physical and mental health was measured by the Patient-Reported Outcome Measurement Information System Global Health-10 (PROMIS-10). All scores were obtained preoperatively and postoperatively at three- and six months. Spearman correlation coefficient (r) was used to assess the relationship between variables. Results Ninety-eight patients ultimately underwent rotator cuff repair; 76 and 68 patients provided three- and six-month follow-up, respectively. There was no statistically significant correlation between preoperative BRS and three- and six-month ASES. However, there was a statistically significant correlation between preoperative BRS and three-month PROMIS-10 (r = 0.3763, p = 0.009) and concurrent BRS and PROMIS-10 at three months (r = 0.5657, p = 0.0025) and six months (r = 0.5308, p = 0.0025). Discussion Resilience appears to be more predictive of global physical and mental health than shoulder pain and function in early recovery from rotator cuff repair.

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“…NSAIDs or acetaminophen) and found that 82% of patients undergoing arthroscopic partial meniscectomy and/or chondroplasty have satisfactory pain control [14]. Furthermore, a case series of 175 patients found that preoperative resilience scores does not correlate with a non-opioid pain regimen following partial meniscectomy and/or chondroplasty [15].…”

Section: Figure 2: Attitudes Towards Opioid Over-prescription As a Prmentioning

confidence: 99%

Narcotic Prescriptions following Knee and Shoulder Arthroscopy: A Survey of the Arthroscopy Association of Canada

Ekhtiari¹,

Horner²,

Shanmugaraj³

et al. 2020

Cureus

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Canada has the second-highest opioid use in the world. Despite knee and shoulder arthroscopy being among the most commonly performed orthopaedic procedures, there exists little guidelines for pain management. Methods A survey was developed and distributed to members of the Arthroscopy Association of Canada. The objectives were: to understand opioid prescribing patterns after knee and shoulder arthroscopy, to determine if surgeons believe opioid over-prescription is an issue and to identify other pain management strategies surgeons are regularly using. Results A total of 38 responses were included (38.3%). Eighty-two percent of surgeons felt opioid overprescription was an issue in arthroscopic surgery. The average post-operative knee or shoulder arthroscopy prescription included a total of 156 +/-84.4 (0-400) mg of oral morphine equivalents (OMEs). Less than one-third of respondents (29%) had received formal perioperative pain management training. Fifty-five percent of respondents felt that non-opioid medications do not provide adequate pain relief after arthroscopic surgery. Nearly all respondents (95%) stated they would change their prescription practice if high-quality evidence were to suggest that they should do so. Conclusions The majority of respondents identified opioid over-prescription as a problem after arthroscopic surgery. Surgeons are prescribing five times the amount of OMEs to patients that previous literature suggests the median patient uses after arthroscopic knee surgery. Surgeons generally state they would reduce or eliminate opioid prescriptions to arthroscopy patients if high-level evidence were to emerge suggesting that adequate pain control could be achieved without the use of narcotics.

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Resilience as a Predictor of Patient Satisfaction With Nonopioid Pain Management and Patient-Reported Outcome Measures After Knee Arthroscopy

Cited by 21 publications

References 17 publications

Patient Resilience Has Moderate Correlation With Functional Outcomes, but Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty

Patient Resilience Has Moderate Correlation With Functional Outcomes, but Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty

Impact of patient resilience on early recovery from rotator cuff repair

Narcotic Prescriptions following Knee and Shoulder Arthroscopy: A Survey of the Arthroscopy Association of Canada

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