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Study: Preoperative ROM, psychological factors may predict post-TKA pain
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CHICAGO — Pain for patients after total knee arthroplasty can be predicted by pain during preoperative range of motion tests, but also with psychological symptoms, such as depression, anxiety and catastrophizing, according to a presenter, here.
“Our study corroborates the findings of others concerning correlations between postoperative pain following [total knee arthroplasty] TKA and depression, anxiety and catastrophizing,” John J. Callaghan, MD, from the University of Iowa, stated in his presentation at the Knee Society Specialty Day Meeting.
John J. Callaghan
Callaghan and colleagues prospectively studied 215 patients’ knee pain intensity at rest, full flexion and full extension both preoperatively and postoperatively. Of these patients, 52% had moderate to severe knee pain before TKA. Two days postoperatively, 70% of patients with moderate to severe knee pain continued to experience pain and this pain correlated with preoperative range of motion (ROM), pain and psychological tests, Callaghan said.
At 6 months, Callaghan said 16% of patients still had moderate to severe pain during active ROM, which still correlated with preoperative knee pain and ROM but also some psychological tests.
Callaghan said interpreting patient pain following TKA is important since health care is moving towards a reimbursement system based on patient satisfaction.
“Governments, not only in the United States, but other governments are considering lower reimbursement or non-reimbursement for surgical outcomes that do not provide appropriate patient satisfaction,” he said.
Reference:
Callaghan JJ. Predictors of pain following total knee arthroplasty. Presented at: Knee Society Specialty Day Meeting; March 23, 2013; Chicago.
Disclosure: Callaghan receives royalties from DePuy. This study was funded by the National Institutes of Health.