Abstract
Objective: To evaluate the association of preoperative psychosocial and demographic factors with total knee arthroplasty (TKA) outcomes and satisfaction in patients with osteoarthritis (OA) of the knee at 24 months after surgery. Methods: A prospective cohort study of patients undergoing TKA was conducted. Outcome measures included: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 36 (SF-36) scores at baseline and 24 months after surgery, and patient satisfaction with TKA at 24 months. Linear regression models were performed to evaluate the association of preoperative psychosocial determinants (ie, Medical Outcome Study Social Support Scale; Depression, Anxiety, and Stress Scale; Brief COPE inventory, The Life Orientation Test-Revised; Multidimensional Health Locus of Control; and Arthritis Self-Efficacy Scale) on outcomes. Results: We included 178 patients. Increasing WOMAC pain scores at 24 months were associated with increasing age and body mass index (BMI); low tangible social support and low optimism were associated with higher levels of pain (R2 = 0.15). A decrease in WOMAC function scores was also associated with older age and higher BMI; low tangible support, increased stress, and low optimism were also associated with worse function (R2 = 0.22). When evaluating quality of life, lower SF-36 physical functioning scores at 24 months were associated with age, high BMI, and comorbidity (R2 = 0.34). Lower SF-36 mental functioning scores were associated with depression and low optimism (R2 = 0.38). Having a dysfunctional style of coping was associated with lower satisfaction with surgery after 24 months (adjusted R2 = 0.12). Conclusion: Psychosocial factors, such as tangible support, depression, dysfunctional coping, and optimism, were associated with pain, function, and satisfaction 2 years after TKA. Perioperative programs identifying and addressing psychosocial problems may result in improvements in pain and function after TKA.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 573-581 |
| Number of pages | 9 |
| Journal | ACR Open Rheumatology |
| Volume | 2 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2020 |
| Externally published | Yes |
Bibliographical note
Funding Information:All authors are grateful to David Edelstein, MD, and Roy B. Smith, MD, who allowed us to recruit their patients for this study. Chong Pak and Sofia de Achaval were instrumental in assisting us with the recruitment and follow-up of patients. We thank Erica Goodoff for her editorial review of this manuscript, she is funded by the University of Texas MD Anderson Cancer Center.
Publisher Copyright:
© 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology