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Comparative Study
. 2025 May;35(3):290-300.
doi: 10.1177/11207000251325230. Epub 2025 Mar 13.

The role of pain catastrophising on subjective function and pain following total hip arthroplasty: a prospective comparative study of 531 patients with 2-year follow-up

Margot B Aalders  1   2   3 , Jelle P van der List  1   2 , Lucien C M Keijser  1   2 , Olivier P P Temmerman  1   2 , Joyce L Benner  1   4   5
Affiliations
Comparative Study

The role of pain catastrophising on subjective function and pain following total hip arthroplasty: a prospective comparative study of 531 patients with 2-year follow-up

Margot B Aalders et al. Hip Int. 2025 May.

Abstract

Background and purpose: Considering dissatisfaction rates of around 10% after total hip arthroplasty (THA), this study aimed to investigate the role of pain catastrophising (PC) on functional outcomes, pain, and quality of life following THA in a large prospective study. PC is the tendency to focus on and exaggerate painful stimuli combined with a decreased ability to deal with pain.

Patients and methods: A prospective comparative study was performed with 531 patients undergoing primary unilateral THA between 2019 and 2020. Patients were considered PC with a preoperative score ⩾30 on the PC Scale, resulting in 57 (11%) PC-patients. Patient-reported outcome measures (PROMs) were collected preoperatively, at 3 months, 1 year, and 2 years postoperatively and consisted of Hip disability and Osteoarthritis Outcome Score-Physical Function (HOOS-PS), Oxford Hip Score (OHS), pain (NRS), and quality of life (EQ-5D), including minimal clinical important differences (MCIDs) and patient acceptable symptom state (PASS), as well as length of stay and aseptic revisions.

Results: PC-patients reported inferior preoperative scores on all PROMs and had longer hospital stay (p = 0.02). Although PC-patients had more improvement in all scores and a higher proportion generally reached MCID, they still reported lower OHS, more pain, and lower EQ-5D at 2-year follow-up (all p < 0.03), and fewer PC-patients reached PASS for OHS and EQ-5D at final follow-up. No difference in aseptic revisions was seen (p = 0.95).

Conclusions: PC-patients had worse preoperative subjective function and more pain. Although they showed more improvement than non-PC patients at all outcomes, less patients reached PASS for OHS and EQ-5D at 2-year follow-up.

Keywords: Arthroplasty; hip osteoarthritis; hip replacement; pain catastrophising; psychological factors; total hip arthroplasty.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A flowchart of the study population, including the number of drop-outs i.e., excluded patients during the inclusion period.
Figure 2.
Figure 2.
The mean and 95% confidence intervals of PC-patients (red – [darker]) and non-PC-patients (blue) with the HOOS-PS (a), OHS (b), NRS Pain (c), and EQ-5D Index (d).
None
See this image and copyright information in PMC

References

    1. Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am 2018; 100: 1455–1460. - PubMed
    1. LROI. Number of registered hip arthroplasties per year of surgery (2007-2021) in the LROI in May 2022, https://www.Lroi-Report.nl/Hip/Numbers/2022 (2022, accessed 08 December 2022).
    1. Toci GR, Magnuson JA, DeSimone CA, et al. A systematic review and meta-analysis of non-database comparative studies on cemented versus uncemented femoral stems in primary elective total hip arthroplasty. J Arthroplasty 2022; 37: 1888–1894. - PubMed
    1. Van Steenbergen LN, Mäkelä KT, Kärrholm J, et al. Total hip arthroplasties in the Dutch Arthroplasty Register (LROI) and the Nordic Arthroplasty Register Association (NARA): comparison of patient and procedure characteristics in 475,685 cases. Acta Orthop 2021; 92: 15–22. - PMC - PubMed
    1. Gademan MGJ, van Steenbergen LN, Cannegieter SC, et al. Population-based 10-year cumulative revision risks after hip and knee arthroplasty for osteoarthritis to inform patients in clinical practice: a competing risk analysis from the Dutch Arthroplasty Register. Acta Orthop 2021; 92: 280–284. - PMC - PubMed

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