Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty

Alattas, Sharifah Adla, Smith, Toby, Bhatti, Maria, Wilson-Nunn, Daniel and Donell, Simon (2017) Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 25 (11). 3403–3410. ISSN 0942-2056

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    Abstract

    Purpose: Around 10–30 % of patients are dissatisfied with the results of their total knee arthroplasty (TKA). This review aimed to identify and evaluate the predictors of outcome measured by the three domains of health-related quality of life (pain, stiffness and function). The focus was on pre-operative psychological factors as related to other patient-related variables. Methods: A systematic search was performed using the following databases: MEDLINE, PubMed, AMED, CINAHL, PsychINFO, SciFinder, Scopus, EMBASE, Cochrane, Lilacs, Web of Science and ScienceDirect. The quality of identified studies was assessed using the Critical Appraisal Skills Programme Cohort checklist. Results: Ten studies met the eligibility criteria. From these, nine patient-related predictors of outcome were identified (depression, anxiety, age at surgery, gender (being female), medical co-morbidities, BMI, level of education, pre-operative pain severity and pre-operative knee function). Greater anxiety, pre-operative pain and function were the most significant factors to predict a poorer outcome of a TKA. The results of depression, gender (female), medical co-morbidities, BMI and level of education were variable among the included studies. There was very little evidence to support older age at operation as a predictor of poorer outcome. Conclusion: Patients experiencing high levels of pain before surgery should be informed of the chances of improvement by having a TKA. A validated psychological screening tool that separates depression and anxiety is recommended as part of the pre-operative assessment stage. Patients presenting with symptoms of depression and anxiety should be identified and consulted before a TKA.

    Item Type: Article
    Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
    Uncontrolled Keywords: total knee arthroplasty,depression,anxiety,results,outcome,quality of life
    Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
    Faculty of Medicine and Health Sciences > Norwich Medical School
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    Depositing User: Pure Connector
    Date Deposited: 24 Sep 2016 01:38
    Last Modified: 25 Jul 2018 12:35
    URI: https://ueaeprints.uea.ac.uk/id/eprint/60156
    DOI: 10.1007/s00167-016-4314-8

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