Postoperative psychosocial factors in health functioning and health-related quality of life after knee arthroplasty: A 6- month follow up prospective observational study

Knee arthroplasty (KA) is an effective and cost-effective treatment for end-stage knee osteoarthritis. Despite high surgical success rates, as many as 25% of patients report compromised postoperative functioning, persistent pain, and reduced quality of life. The purpose of this study was to assess t...

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Bibliographic Details
Authors: Terradas-Monllor, Marc, Navarro-Fernández, Gonzalo, Ruiz, Miguel A., Beltran-Alacreu, Hector, Fernández-Carnero, Josué, Salinas-Chesa, Julio, Ochandorena Acha, Mirari
Format: article
Publication Date:2021
Country:España
Institution:UVic-UCC
Repository:RiUVic. Repositori institucional de la UVic-UCC
OAI Identifier:oai:dspace.uvic.cat:10854/7604
Online Access:http://hdl.handle.net/10854/7604
https://doi.org/10.1093/pm/pnab025
Access Level:Open access
Keyword:Genolls
Artroplàstia
Artrosi
Qualitat de vida
Description
Summary:Knee arthroplasty (KA) is an effective and cost-effective treatment for end-stage knee osteoarthritis. Despite high surgical success rates, as many as 25% of patients report compromised postoperative functioning, persistent pain, and reduced quality of life. The purpose of this study was to assess the predictive value of psychological factors in health functioning and quality of life, during a 6-month period after KA. Design. A prospective observational study. Setting. Surgery at two hospitals and follow-up was carried out through the domiciliary rehabilitation service. Subjects. In total, 89 patients (age 70.2767.99 years) met the inclusion criteria. Method. A test battery composed of Health functioning associated with osteoarthritis (WOMAC), Health-related quality of life (EQ-5D-5L), Anxiety and Depression (HADS), Pain attitudes (SOPA-B), Pain catastrophizing (PCS), and Fear of Movement (TSK11) was assessed at 1 week, and 1, 3, and 6 months after surgery. A mixed effects linear model was used to estimate the effect of time and covariates. An exploratory factor analysis was used to identify the number of dimensions underlying the group of psychological measurements. Results. In WOMAC model, anxiety level (F - 120.8), PCS (F - 103.9), depression level (F - 93.6) and pain score (F - 72.8) were the most influential variables. Regarding EQ5D-5L model, anxiety level (F = 98.5), PCS (F - 79.8), depression level (F - 78.3) and pain score (F - 45) were the most influential variables. Pain score and the psychosocial variables of PCS, TSK, HADS-A, HADS-D, SOPA-B Emotion, SOPA-B Harm and SOPA-B Disability loaded in one single dimension. Conclusions. Postoperative acute pain and psychosocial factors of pain catastrophizing, anxiety, depression, and pain attitudes might influence health functioning and quality of life during KA rehabilitation. Such factors could be gathered into one single dimension defined as pain-related psychologic distress.