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Knee Surg Sports Traumatol Arthrosc. 2016 Oct;24(10):3322-3328. Epub 2015 Dec 19.

Patient kinesiophobia affects both recovery time and final outcome after total knee arthroplasty.

Author information

1
Laboratory of Biomechanics and Technology Innovation/2nd Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, Bologna, Italy.
2
Laboratory of NanoBiotechnology (NABI), Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, Bologna, Italy. a.roffi@biomec.ior.it.
3
Laboratory of NanoBiotechnology (NABI), Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, Bologna, Italy.
4
Mood, Centro per lo studio e la cura dei disturbi emotivi, Bologna, Italy.
5
Mental Health Department, AUSL Bologna, Bologna, Italy.

Abstract

PURPOSE:

To evaluate the effects of kinesiophobia on both phases immediately after surgery and the final results after total knee arthroplasty (TKA).

METHODS:

This study evaluated prospectively 101 patients (mean age 66 ± 8.0 years, 70 women and 31 men), 5 days after surgery, at 1, 6, 12 months, and at a mean final follow-up of 3.2 ± 0.7 years (2.0-4.2 years). Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK: Activity Avoidance-TSK1 and Harm-TSK2 subscales), and results were evaluated with range of motion, pain and function on 0-10 numeric rating scales, WOMAC and SF-12 (Physical and Mental subscales) scores.

RESULTS:

TSK1 was correlated with the acute postoperative pain measured at 5 days (p = 0.031), pain measured at 12 months (p = 0.018), patient perceived function at 12 months (p = 0.025), SF-12P at 6 months (p < 0.001), SF-12P and SF-12M at 12 months (p = 0.001 and p = 0.005, respectively), and WOMAC at both 6 and 12 months of follow-up (p = 0.005 and p = 0.001). The effect of TSK 1 on the final WOMAC score was significant when corrected by age and sex (p = 0.049, η 2 = 0.041): the youngest female patients were affected even by moderate kinesiophobia levels.

CONCLUSIONS:

Fear of pain and even more avoidance of movement are strongly correlated both with the acute postoperative pain perception and recovery after surgery up to 1 year, thus presenting a relevant clinical impact on the outcome after TKA. Moreover, this study showed that even though at longer follow-up its impact decreases, patients with higher levels of kinesiophobia may present a poorer final outcome, especially women.

LEVEL OF EVIDENCE:

IV.

KEYWORDS:

Catastrophizing; Kinesiophobia; TKA; TKR; Total knee arthroplasty; Total knee replacement

PMID:
26685685
DOI:
10.1007/s00167-015-3898-8
[Indexed for MEDLINE]

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