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Erschienen in: International Orthopaedics 10/2020

08.08.2020 | Original Paper

Does cognitive behavioral education reduce pain and improve joint function in patients after total knee arthroplasty? A randomized controlled trial

verfasst von: Jian-Ning Sun, Wang Chen, Yu Zhang, Ye Zhang, Shuo Feng, Xiang-Yang Chen

Erschienen in: International Orthopaedics | Ausgabe 10/2020

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Abstract

Introduction

Cognitive behavioral therapy (CBT) is an effective treatment for reducing the pain of knee osteoarthritis (OA) and improving joint function. However, there are few studies on the effect of CBT on the pain severity after total knee arthroplasty (TKA). This study investigates the effectiveness of a CBT program on pain, knee function, quality of life, and pain catastrophizing in patients after TKA.

Methods

This was a randomized, parallel-group, controlled trial in which 100 patients with knee osteoarthritis (OA) prepared for TKA were randomly assigned to participate in CBT or usual care group. Evaluation outcomes include Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), Oxford Knee Score (OKS), Knee Range of Motion (ROM), EuroQol Five-Dimensional (EQ-5D), and Hospital for Special Surgery (HSS) Knee Rating Scale before and after surgery.

Results

We found that patients in the CBT group had a lower pain during activity from the fifth day (p = 0.003) to the third month (p = 0.019) after TKA. At the 12th month, the mean VAS score during activity in the CBT and usual care groups decreased from 4.5 to 0.8 and from 4.6 to 0.9, respectively, and there is no significant difference between the two groups. The PCS scores of patients in the CBT group were lower than those in the usual care group at 1st (p = 0.014) and 3rd months (p = 0.027) after surgery. No statistically significantly differences between the two groups in pain during rest, knee ROM, EQ-5D, OKS, and HSS.

Conclusions

The CBT program was superior to usual care in reducing post-operative pain during activity from the fifth day to the third month and pain catastrophing in the first three months after TKA but has no statistically significantly differences in pain during rest, knee ROM, EQ-5D, OKS, and HSS.

Trial registration

Current Controlled Trials ChiCTR2000032857, date of registration: May, 14, 2020, retrospectively registered.
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Metadaten
Titel
Does cognitive behavioral education reduce pain and improve joint function in patients after total knee arthroplasty? A randomized controlled trial
verfasst von
Jian-Ning Sun
Wang Chen
Yu Zhang
Ye Zhang
Shuo Feng
Xiang-Yang Chen
Publikationsdatum
08.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 10/2020
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04767-8

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