The associations of pain catastrophizing and post-operative outcomes in domains of pain, quality of life and function in joint replacement surgery: a systematic review.

Lorelle Dismore, Anna Van Wersch, R Critchley, A Murty, Katherine Swainston

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Abstract

The National Institute for Health and Care Excellence (NICE) guidelines aim to identify the best approach for recovery and rehabilitation to enable clinicians to treat patients more effectively and efficiently. Identification of the pre-surgical modifiable psychosocial risk factors that impact on post-operative recovery offers an opportunity to develop effective and appropriate interventions to facilitate patient’s recovery, which in turn will improve outcomes. A psychological construct termed pain catastrophizing has been identified as a unique predictor of chronic post-surgical pain. The clinical importance of pain catastrophizing in moderating surgical outcomes is well documented in musculoskeletal disorders and is considered one of the key predictors of post-operative pain intensity, delayed recovery, poorer quality of life and perceived disability. Objective: To identify whether pain catastrophizing affects post-surgical outcomes following joint replacement surgery in relation to pain, function and quality of life. Study group: joint replacement surgery. Methods: Systematic review identifying eight studies assessing catastrophizing and post-operative outcomes in domains of pain, quality of life and/or function. Results: The analysis of the results are limited to a qualitative synthesis of the eligible studies. Pain catastrophizing was associated with all domains; patients with high pain catastrophizing symptoms were more symptomatic post-surgery, experienced more pain and rated themselves as dissatisfied; dissatisfied patients experienced lower quality of life. Pain catastrophizing is a useful prognostic indicator for identifying individuals at-risk for poorer post-operative outcomes. Conclusions: A multidisciplinary approach with an appropriate intervention to reduce catastrophizing symptoms preoperatively may optimise post-operative outcomes following joint replacement.
Original languageEnglish
JournalJournal of Pain Management
Publication statusAccepted/In press - 18 May 2020

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