Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement
DOI:
https://doi.org/10.1080/17453674.2017.1334180Abstract
Background and purpose — Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods — 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results — Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation — Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years postoperative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.Downloads
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Published
2017-09-03
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Wylde, V., Trela-Larsen, L., Whitehouse, M. R., & Blom, A. W. (2017). Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement. Acta Orthopaedica, 88(5), 530–536. https://doi.org/10.1080/17453674.2017.1334180
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Copyright (c) 2017 Vikki Wylde, Lea Trela-Larsen, Michael R Whitehouse, Ashley W Blom
This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.
Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.