Negative pain thoughts may be linked with poor outcomes after arthroscopic meniscectomy
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Key takeaways:
- Negative pain thoughts may be associated with poor outcomes after arthroscopic meniscectomy.
- Preoperative negative pain thoughts were associated with poor postoperative SF-12, IKDC and VAS pain scores.
Patients with increased levels of negative pain thoughts may have poor patient-reported outcomes, knee function and general health after arthroscopic meniscectomy, according to published data.
Brian Johnson, MD, resident physician from the department of orthopedic surgery at the University of Cincinnati, and colleagues performed a single-center, prospective, observational cohort study of 92 patients (mean age, 52.5 years) who underwent arthroscopic meniscectomy with follow-up between 3 months and 1 year.
Johnson and colleagues used the Negative Pain Thoughts Questionnaire Short Form (NPTQ-SF) to analyze the effect of negative cognitive biases about pain on several outcomes including SF-12 scores, IKDC scores and VAS pain scores.
Johnson and colleagues found preoperative NPTQ-SF scores were significantly negatively associated with IKDC scores, SF-12 physical health scores, SF-12 mental health scores and VAS pain scores at a mean postoperative follow-up of 108.5 days.
They also found patients with a preoperative NPTQ-SF score greater than 8 were less likely to achieve the patient-acceptable symptom state for postoperative IKDC score compared with patients with a preoperative NPTQ-SF score of 8 or less (39% vs. 63%).
“It is important to identify patients at risk by screening for these negative cognitive biases in the presurgical evaluation,” Johnson and colleagues wrote in the study.
Perspective
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The article by Brian Johnson, MD, and colleagues titled "Negative pain thoughts questionnaire short form (NPTQ-SF) scores and outcomes after arthroscopic meniscectomy" investigated the relationship between negative pain thoughts and postoperative outcomes in patients undergoing arthroscopic meniscectomy. The NPTQ-SF was used to assess patients' cognitive biases related to pain. The key finding from this study is that there was a significant relationship between the level of negative pain thoughts and all functional outcome measures both preoperatively and postoperatively.
As a result of their findings, the authors suggest screening for negative pain thoughts preoperatively and potentially referring those patients for psychosocial interventions prior to indicating for arthroscopic meniscectomy. In addition, they suggest patients with high levels of negative pain thoughts may not be appropriate candidates for arthroscopic meniscectomy due to the correlation with poorer functional outcomes and may be more appropriately treated with nonsurgical measures.
Given the authors’ findings of the negative impact of negative pain thoughts on outcomes after arthroscopic meniscectomy, this study serves as a good reminder that it is imperative to treat the patient holistically.
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