Postoperative psychological predictors for chronic postsurgical pain after a knee arthroplasty: a prospective observational study

Objective: Persistent postsurgical pain is a significant adverse effect shown in around 20% of the subjects who had undergone a knee arthroplasty. Psychological risk factors emerged as a significant and potentially modifiable risk factors for its development. Nevertheless, there is still little evid...

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Detalles Bibliográficos
Autores: Terradas Monllor, Marc, Ruiz Díaz, Miguel Ángel, Ochandorena Acha, Mirari
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:repositorio.uam.es:10486/716950
Acceso en línea:http://hdl.handle.net/10486/716950
https://dx.doi.org/10.1093/ptj/pzad141
Access Level:acceso abierto
Palabra clave:knee arthroplasty
orthopedic procedures
rehabilitation
persistent postsurgical pain
psychological factors
pain catastrophizing
Psicología
Descripción
Sumario:Objective: Persistent postsurgical pain is a significant adverse effect shown in around 20% of the subjects who had undergone a knee arthroplasty. Psychological risk factors emerged as a significant and potentially modifiable risk factors for its development. Nevertheless, there is still little evidence when assessing them during the acute postoperative period. The present study aimed to assess the predictive value of postoperative pain catastrophizing, pain-related fear of movement, anxiety, depression, and pain attitudes developing persistent postsurgical pain after knee arthroplasty. Methods: A six-month follow-up prospective observational study design was used. The study sample comprised 115 subjects who underwent a knee arthroplasty due to painful primary osteoarthritis. Measures of pain catastrophizing, pain-related fear of movement, anxiety, depression, and pain attitudes were obtained one week after surgery. Persistent postsurgical pain was set at an intensity of ≥30 using a 100mm visual analogue scale three and six months after surgery. Results: Analysis revealed that pain catastrophizing, pain-related fear of movement, anxiety, depression, and maladaptive pain attitudes are significant predictors of persistent pain at 3 and 6 months after surgery in a univariate analysis. However, at three months after surgery, only pain catastrophizing would be needed as a predictor in the final multivariate model forecasting disturbing pain. Moreover, six months after surgery, pain catastrophizing and distrust in medical procedures remained independent predictors. Conclusion: The results suggest that postoperative pain catastrophizing and pain attitudes are independent predictors for persistent postsurgical pain after knee arthroplasty. Impact: Postoperative cognitive and emotional factors should be considered during postoperative rehabilitation after knee arthroplasty since they could influence the development of persistent postsurgical pain after knee arthroplasty