TY - JOUR
T1 - The influence of preoperative psychological distress on pain and function after total knee arthroplasty
T2 - A systematic review and meta-analysis
AU - Sorel, J. C.
AU - Veltman, E. S.
AU - Honig, A.
AU - Poolman, R. W.
PY - 2019
Y1 - 2019
N2 - We performed a meta-analysis investigating the association between preoperative psychological distress and postoperative pain and function after total knee arthroplasty (TKA). Materials and Methods Pubmed/Medline, Embase, PsycINFO, and the Cochrane library were searched for studies on the influence of preoperative psychological distress on postoperative pain and physical function after TKA. Two blinded reviewers screened for eligibility and assessed the risk of bias and the quality of evidence. We used random effects models to pool data for the meta-analysis. Results Six prospective cohort studies, with a total of 1525 patients, were included. The random effects models showed significantly poorer outcomes in patients who preoperatively had elevated scores on the pain catastrophizing scale, worse 36-Item Short-Form Health Survey (SF-36) mental health score, symptoms of anxiety and/or depression, and somatization dysfunction. After 12 months, the standard mean difference for pain was -0.74 (95% confidence interval (CI) -1.04 to -0.44) and -0.56 (95% CI -0.80 to -0.32) for function. Conclusion Preoperative pain catastrophizing, mental distress, symptoms of anxiety and/or depression, and somatoform disorders appear to adversely affect pain and function after TKA. Some patients undergoing TKA may therefore need psychological support to improve the outcome and quality of life.
AB - We performed a meta-analysis investigating the association between preoperative psychological distress and postoperative pain and function after total knee arthroplasty (TKA). Materials and Methods Pubmed/Medline, Embase, PsycINFO, and the Cochrane library were searched for studies on the influence of preoperative psychological distress on postoperative pain and physical function after TKA. Two blinded reviewers screened for eligibility and assessed the risk of bias and the quality of evidence. We used random effects models to pool data for the meta-analysis. Results Six prospective cohort studies, with a total of 1525 patients, were included. The random effects models showed significantly poorer outcomes in patients who preoperatively had elevated scores on the pain catastrophizing scale, worse 36-Item Short-Form Health Survey (SF-36) mental health score, symptoms of anxiety and/or depression, and somatization dysfunction. After 12 months, the standard mean difference for pain was -0.74 (95% confidence interval (CI) -1.04 to -0.44) and -0.56 (95% CI -0.80 to -0.32) for function. Conclusion Preoperative pain catastrophizing, mental distress, symptoms of anxiety and/or depression, and somatoform disorders appear to adversely affect pain and function after TKA. Some patients undergoing TKA may therefore need psychological support to improve the outcome and quality of life.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059384018&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30601044
U2 - 10.1302/0301-620X.101B1.BJJ-2018-0672.R1
DO - 10.1302/0301-620X.101B1.BJJ-2018-0672.R1
M3 - Article
C2 - 30601044
VL - 101B
SP - 7
EP - 14
JO - Bone & joint journal
JF - Bone & joint journal
SN - 2049-4394
IS - 1
ER -