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

Objective 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 t...

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Detalles Bibliográficos
Autores: Terradas Monllor, Marc, Navarro Fernández, Gonzalo, Ruiz , Miguel A, Fernández Carnero, Josué, Salinas Chesa, Julio, Ochandorena Acha, Mirari, Beltrán Alacreu, Héctor
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/45398
Acceso en línea:https://hdl.handle.net/10578/45398
Access Level:acceso abierto
Palabra clave:Health functioning
Health quality of life
Knee arthroplasty
Knee osteoarthritis
Psychosocial factor
Descripción
Sumario:Objective 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 70.27 ± 7.99 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 (TSK-11) 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 EQ-5D-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.