The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty

Abstract

BackgroundPain catastrophizing contributes to acute and long-term pain after knee arthroplasty (KA), but the association between pain catastrophizing and physical function is not clear.We examined the association between preoperative pain catastrophizing and physical function one year after surgery, as well as differences in physical function, pain and general health in two groups of patients with high and low preoperative pain catastrophizing score.MethodsWe included 615 patients scheduled for KA between March 2011 and December 2013. Patients completed The Pain Catastrophizing Scale (PCS) prior to surgery. The Oxford Knee Score (OKS), Short Form-36 (SF-36) and the EuroQol-5D (EQ-5D) were completed prior to surgery, and 4 and 12\u2009months after the surgery.ResultsOf the 615 patients, 442 underwent total knee arthroplasty (TKA) and 173 unicompartmental knee arthroplasty (UKA). Mean age was 67.3 (SD: 9.7) and 53.2% were females. Patients with PCS\u2009>\u200921 had statistically significantly larger improvement in mean OKS for both TKA and UKA than patients with PCS\u2009<\u200911; 3.2 (95% CI: 1.0, 5.4) and 5.4 (95% CI: 2.2, 8.6), respectively. Furthermore, patients with preoperative PCS\u2009>\u200921 had statistically significantly lower OKS, SF-36 and EQ-5D and higher pain score than patients with PCS\u2009<\u200911 both preoperatively and 4 and 12\u2009months postoperatively.ConclusionsPatients with high levels of preoperative pain catastrophizing have lower physical function, more pain and poorer general health both before and after KA than patients without elevated pain catastrophizing.