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Influence of anxiety and pain catastrophizing on the course of pain within the first year after uncomplicated total knee replacement: a prospective study

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Prolonged postoperative pain is a frequent problem after uncomplicated total knee replacement (TKR). The purpose of this study was to evaluate the effect of anxiety and pain catastrophizing on postoperative pain after TKR.

Methods

A total of 150 patients were enrolled in this prospective study. Preoperatively, anxiety was assessed using the State-Trait Anxiety Inventory (STAI) and pain catastrophizing was assessed using the Pain Catastrophizing Scale (PCS). The primary outcome measure was postoperative pain on a numerical rating scale (NRS). The secondary outcome parameters were the different Knee Osteoarthritis Outcome Score (KOOS) subscales and patient satisfaction. Intergroup differences were tested with an independent t test. The odds ratio was calculated to determine the probability of an unsatisfactory outcome.

Results

Preoperatively and at 6 and 12 months postoperatively, patients with anxiety and particularly patients with pain catastrophizing usually had a higher NRS score, lower knee function before and after surgery, and higher dissatisfaction. These intergroup differences were significant preoperatively and at 6 months postoperatively.

Conclusions

Psychopathologic factors, particularly pain catastrophizing, have an impact on postoperative pain after TKR. Preoperative screening and concurrent treatment of the diagnosed psychological disorder may improve patient-perceived outcomes.

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Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Berlin Grunewald, Caspar Theyss Strasse 27-31, 14 193, Berlin, Germany

    Sebastian Bierke & Wolf Petersen

Authors
  1. Sebastian Bierke
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  2. Wolf Petersen
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Corresponding author

Correspondence to Wolf Petersen.

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Funding

There are no financial conflicts related to the study.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (ethic vote no. EA1/305/13) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

W. Petersen receives consultant fees form Karl Storz, Otto Bock and AAP implants. W. Petersen receives lecture fees form Plasmaconcept.

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Bierke, S., Petersen, W. Influence of anxiety and pain catastrophizing on the course of pain within the first year after uncomplicated total knee replacement: a prospective study. Arch Orthop Trauma Surg 137, 1735–1742 (2017). https://doi.org/10.1007/s00402-017-2797-5

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  • DOI: https://doi.org/10.1007/s00402-017-2797-5

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