Understanding the apprehension and concern haunting patients before a total knee arthroplasty

Abstract

Purpose The aim of this prospective study was to understand the fear and apprehension factors that play on patient’s mind before total knee arthroplasty. Methods This retrospective cohort study included 500 consecutive patients (375 females and 125 males) who were scheduled to undergo total knee arthroplasty the next day. The patients were asked to list the most important fear in their mind regarding the operation in descending order of importance. They were given a questionnaire form which contained several capture points, including age, gender, educational background, occupation, and provision of help at home. Preoperative pain was measured by using the visual analog score, and its influence on the patients’ fear and apprehension factors was also measured. Results In this study, 58% of patients (50 males, 40%; 240 females, 64%) were fearful of the pain that they would experience after surgery and during the postoperative physiotherapy. The female patients showed more fear of pain than their male counterparts (P < 0.05). 18% of the patients (40 males, 32%; 50 females, 13%) listed whether they will be able to walk and perform activities of daily living after surgery as the most important fear. The male patients had more fear of returning to normal walking (P < 0.05). 20% of the patients (30 males, 24%; 70 females, 19%) were fearful about getting adequate home help after discharge from hospital (P > 0.05). 4% of patients were concerned about withstanding such a major operation. There was no difference between male and female patients (P > 0.05). Conclusion The majority of the patients experience apprehension of pain in the perioperative period of TKA. Preoperative counseling benefits pain management by alleviating the patient’s concerns about the fear of postoperative pain and apprehension of returning to normal walking.

Patients’ perspectives on the benefits of feedback on patient-reported outcome measures in a web-based personalized decision report for hip and knee osteoarthritis

“…Our third finding of building confidence and trust highlights patients’ perceptions of the importance of decreasing fear or anxiety in the decision-making process. In previous research, patients expressed concerns and information needs related to postoperative function and quality of life and trust of physician [ 48 – 50 ]. As identified by our participants, a PROM-based report may help alleviate these concerns.…”

Pain Catastrophizing, Kinesiophobia and Exercise Adherence in Patients After Total Knee Arthroplasty: The Mediating Role of Exercise Self-Efficacy

“…In this study, we focused on pain-related catastrophizing and kinesiophobia among post-TKA patients, while previous evidence also indicated that pre-TKA pain-related fear and anxiety were common, which are harmful for patients' recovery. 59 Therefore, pre-TKA pain-related catastrophizing and kinesiophobia should be paid more attention in future studies. Furthermore, post-TAK patients need to continue functional exercise.…”

Implementing a pragmatic clinical trial to tailor opioids for acute pain on behalf of the IGNITE ADOPT PGx investigators

“…Postoperative pain is a major concern for patients. 34 , 35 Indeed, there is significant interpatient variability in response to opioid analgesics, and CYP2D6 PMs and IMs may attain little to no relief from some opioids prescribed for postsurgical pain (i.e., hydrocodone, tramadol, and codeine). Opioid misuse and addiction are additional concerns with postoperative opioid use, and there is evidence that 6% of opioid naïve patients who fill a peri‐operative opioid prescription continue to use opioids 3–6 months following a surgical procedure.…”

“…Postoperative pain is a major concern for patients 34,35 . Indeed, there is significant interpatient variability in response to opioid analgesics, and CYP2D6 PMs and IMs may attain little to no relief from some opioids prescribed for postsurgical pain (i.e., hydrocodone, tramadol, and codeine).…”