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. 2018 Jun 18;16(1):126.
doi: 10.1186/s12955-018-0955-2.

The prognostic value of pain catastrophizing in health-related quality of life judgments after Total knee arthroplasty

Esther Yakobov  1 , William Stanish  2 , Michael Tanzer  3 , Michael Dunbar  2 , Glen Richardson  2 , Michael J L Sullivan  4
Affiliations

The prognostic value of pain catastrophizing in health-related quality of life judgments after Total knee arthroplasty

Esther Yakobov et al. Health Qual Life Outcomes. .

Abstract

Background: Total knee arthroplasty (TKA) is a highly effective procedure that yields reductions in pain and disability associated with end stage osteoarthritis (OA) of the knee. Quality of life instruments are frequently used to gauge the outcomes of total knee arthroplasty (TKA). However, research suggests that post-TKA reductions in symptom severity may not be the sole predictors of quality of life post-TKA. The primary objective of the present study was to examine the prognostic value of catastrophic thinking in health-related quality of life (HRQoL) judgments in patients with severe OA after TKA.

Methods: In this study we used a prospective cohort design to examine the value of pain catastrophizing in predicting HRQoL 1 year after TKA. Participants with advanced OA of the knee who were scheduled for TKA were recruited at one of three hospitals in Canada. The study sample consisted of 116 individuals (71 women, 45 men) who completed study questionnaires at their pre-surgical evaluation and 1 year after surgery. Hierarchical regression analysis was used to assess the unique contribution of pre-surgical pain catastrophizing to the prediction of post-surgical HRQoL judgments.

Results: The results of the hierarchical regression equation revealed that the overall model was significant, F (9,106) = 8.3, p < 001, and accounted for 36.4% of the variance in the prediction of post-surgical physical component score of HRQoL. Pain catastrophizing was entered in the last step of the equation and contributed significant unique variance (β = -.35, p < .001) to the prediction of post-surgical physical component score of HRQoL above and beyond the variance accounted for by demographic variables, co-morbid health conditions, baseline HRQoL, and post-surgical reductions in pain, joint stiffness and physical disability.

Conclusions: The current findings highlight the importance of pre-surgical catastrophic cognitions in influencing HRQoL judgments after TKA. The findings suggest that psychosocial interventions designed to reduce pain catastrophizing before TKA might contribute to better quality of life outcomes following surgery.

Keywords: Health-related quality of life; Osteoarthritis; Pain catastrophizing.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in this study were in accordance with the ethical standards of the Research Ethics Boards of the McGill University Health Centre, the Hôpital Maisonneuve-Rosemont, the Capital Health Authority of Nova Scotia, and with the 1964 Helsinki declaration and its later amendments.

Consent for publication

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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