Prognostic Factors for Functional Outcome of Total Knee Replacement: A Prospective Study

Abstract

Psychosocial variables are significantly related to total knee replacement functional outcome. Assessment of baseline psychological and social functioning may identify a subset of patients at risk for worse outcome. Specific interventions for these patients should be developed and evaluated as components of patient management prior to and after the procedure.

Preoperative Pain Catastrophizing Predicts Pain Outcome after Knee Arthroplasty

“…The literature has suggested psychologic distress is an important predictor for poor outcome after knee arthroplasty [1,2,5,14,34,47], but we found no studies that quantified the effects of specific psychologic disorders or health-related beliefs on pain or physical function outcome. Ayers et al [2] found that patients who had knee arthroplasty with SF-36 MCS scores less than 50 had higher levels of catastrophizing, depression, and anxiety than patients with scores of 50 or greater.…”

“…They did not, however, report whether these specific psychologic distress measures predicted outcome independent of the more general SF-36 MCS score. Given that most studies have used general measures of psychologic distress in lieu of specific measures of disorders or pain-related beliefs [1,2,5,14,34,47], a study of these more specific constructs and their impact is needed. We hypothesized that one or more of the specific psychologic disorders or health-related beliefs that we studied would predict poor outcome.…”

“…Several groups of researchers have documented the predictive role of preoperative psychologic distress on arthroplasty outcome [1,2,4,5,14,26,34,47]. The most common approach to quantifying psychologic distress in these studies [1,2,35,47] was to use a global measure, the Mental Health score or the Mental Component Summary (MCS) score of the SF-36 [30], in lieu of more specific measures of psychologic status.…”

“…The most common approach to quantifying psychologic distress in these studies [1,2,35,47] was to use a global measure, the Mental Health score or the Mental Component Summary (MCS) score of the SF-36 [30], in lieu of more specific measures of psychologic status. Use of global psychologic distress measures does not assist in guiding the type of psychologic treatment that may be most valuable.…”

Functional gain following knee replacement in patients aged 75 and older: a prospective follow-up study

“…The expectations and motivation of the patient certainly play a role [16], but previously the qualities of a patient have not been very good at predicting the results [15]. The study on the effect of gender or obesity has been conflicting [13], as well as research on the effect of number of comorbidities [15,17].…”