Abstract
Background:
Total knee arthroplasty (TKA) is a common surgical intervention for end-stage knee osteoarthritis, yet up to 20 % of patients report dissatisfaction with surgery. Pre-operative psychological factors may be associated with post-operative outcomes, yet their relationship remains unclear.
Objectives:
To examine the correlation between pre-operative pain catastrophising and resilience with post-operative outcomes in primary total knee arthroplasty patients.
Design:
Systematic literature review.
Method:
Five databases were searched until July 2024. Studies investigating correlations between pre-operative pain catastrophising or resilience and post-operative outcomes were included. Study selection was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Results of individual studies were extracted and described through narrative and tabular synthesis. Study comparisons between pre-operative psychological measures and post-operative outcomes were grouped and reported on.
Results:
Fourteen studies (2,506 patients) were included. Pain catastrophising showed consistent correlations with post-operative pain intensity and self-reported function in most studies. Lower pre-operative resilience was associated with reduced post-operative self-reported function and physical performance in some studies. However, neither pain catastrophising nor resilience demonstrated correlations with physical performance, analgesic requirements, psychometric outcomes, or length of hospital stay.
Conclusions:
This review found that pre-operative pain catastrophising consistently correlates with post-operative pain and functional outcomes, while the association with resilience was less conclusive. These findings suggest potential value in pre-operative psychological screening, particularly for pain catastrophising, to identify patients who may benefit from targeted interventions.
Total knee arthroplasty (TKA) is a common surgical intervention for end-stage knee osteoarthritis, yet up to 20 % of patients report dissatisfaction with surgery. Pre-operative psychological factors may be associated with post-operative outcomes, yet their relationship remains unclear.
Objectives:
To examine the correlation between pre-operative pain catastrophising and resilience with post-operative outcomes in primary total knee arthroplasty patients.
Design:
Systematic literature review.
Method:
Five databases were searched until July 2024. Studies investigating correlations between pre-operative pain catastrophising or resilience and post-operative outcomes were included. Study selection was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Results of individual studies were extracted and described through narrative and tabular synthesis. Study comparisons between pre-operative psychological measures and post-operative outcomes were grouped and reported on.
Results:
Fourteen studies (2,506 patients) were included. Pain catastrophising showed consistent correlations with post-operative pain intensity and self-reported function in most studies. Lower pre-operative resilience was associated with reduced post-operative self-reported function and physical performance in some studies. However, neither pain catastrophising nor resilience demonstrated correlations with physical performance, analgesic requirements, psychometric outcomes, or length of hospital stay.
Conclusions:
This review found that pre-operative pain catastrophising consistently correlates with post-operative pain and functional outcomes, while the association with resilience was less conclusive. These findings suggest potential value in pre-operative psychological screening, particularly for pain catastrophising, to identify patients who may benefit from targeted interventions.
| Original language | English |
|---|---|
| Article number | 103371 |
| Pages (from-to) | 1-9 |
| Number of pages | 9 |
| Journal | Musculoskeletal Science and Practice |
| Volume | 78 |
| DOIs | |
| Publication status | Published - Aug 2025 |