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International Orthopaedics

Erschienen in:

03.04.2020 | Original Paper

Personality traits predict residual pain after total hip and knee arthroplasty

verfasst von: Michele Mercurio, Giorgio Gasparini, Elvira Anna Carbone, Olimpio Galasso, Cristina Segura-Garcia

Erschienen in: International Orthopaedics | Ausgabe 7/2020

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Abstract

Aim of the study

We assessed the role of personality traits, anxiety, and depression in residual pain among patients who underwent total hip (THA) and knee (TKA) arthroplasty.

Method

Eighty-three patients (40 THA and 43 TKA) were interviewed pre-operatively (t₀); five days (t₁) after surgery; and one (t₂), three (t₃), six (t₄), and 12 months (t₅) after surgery. Personality (TCI-R), pain (VAS), anxiety and depression (HADS), quality of life (SF-12), functionality (HHS/KSS), and disability (WOMAC) were evaluated.

Results

Pain reduction and functional improvement were reported at t₅ (both p < 0.001) in both THA and TKA patients. THA patients showed earlier and greater functional improvement after surgery (both p < 0.001) in comparison with TKA. Residual pain (VAS > 30 mm) was noted in 15% of the THA patients and 25% of the TKA patients, and it correlated with the SF-12 PCS (r² = − 0.412; p < 0.001), SF-12 MCS (r² = − 0.473; p < 0.001), HADS-A (r² = 0.619; p = <0.001), HADS-D (r² = 0.559; p < 0.001), functionality (r² = − 0.482; p < 0.001), and WOMAC (r² = 0.536; p < 0.001) scores at t₅. High pre-operative harm avoidance, persistence, and anxiety scores were predictive of residual pain after both THA and TKA (p < 0.001).

Discussion

The proportion of patients complaining of residual pain in this study was similar to that in previous findings. Multiple predictors of residual pain after THA and TKA have been previously described, and several studies evaluated the influence of psychological factors on the outcome of joint arthroplasty; however, only four studies investigated the role of personality traits in the outcome of THA and TKA patients, and a unique study out of these investigations demonstrated the effect of personality on persisting pain.

Conclusion

The current study demonstrated that personality traits and anxiety predict residual pain; thus, pre-operative evaluation of these factors could be helpful in identifying patients at risk for residual pain.

Hofmann S, Seitlinger G, Djahani O, Pietsch M (2011) The painful knee after TKA: a diagnostic algorithm for failure analysis. Knee Surg Sports Traumatol Arthrosc 19:1442–1452. https://doi.org/10.1007/s00167-011-1634-6 CrossRefPubMed

Izumi M, Petersen KK, Laursen MB et al (2017) Facilitated temporal summation of pain correlates with clinical pain intensity after hip arthroplasty. Pain 158:323–332. https://doi.org/10.1097/j.pain.0000000000000764 CrossRefPubMed

Conrad R, Schilling G, Bausch C et al (2007) Temperament and character personality profiles and personality disorders in chronic pain patients. Pain 133:197–209. https://doi.org/10.1016/j.pain.2007.07.024 CrossRefPubMed

Fossati A, Cloninger CR, Villa D et al (2007) Reliability and validity of the Italian version of the temperament and character inventory-revised in an outpatient sample. Compr Psychiatry 48:380–387CrossRef

Sorel JC, Veltman ES, Honig A, Poolman RW (2019) The influence of preoperative psychological distress on pain and function after total knee arthroplasty: a systematic review and meta-analysis. Bone Joint J 101-B:7–14. https://doi.org/10.1302/0301-620X.101B1.BJJ-2018-0672.R1 CrossRefPubMed

Vogel M, Riediger C, Krippl M et al (2019) Negative affect, type D personality, quality of life, and dysfunctional outcomes of total knee arthroplasty. Pain Res Manag 2019:1–9. https://doi.org/10.1155/2019/6393101 CrossRef

Duivenvoorden T, Vissers MM, Verhaar JAN et al (2013) Anxiety and depressive symptoms before and after total hip and knee arthroplasty: a prospective multicentre study. Osteoarthr Cartil 21:1834–1840. https://doi.org/10.1016/j.joca.2013.08.022 CrossRefPubMed

Zhai H, Geng H, Bai B, Wang Y (2019) Differences in 1-year outcome after primary total hip and knee arthroplasty : a cohort study in older patients with osteoarthritis. Orthopade 48:136–143. https://doi.org/10.1007/s00132-018-3636-2 CrossRefPubMed

Erlenwein J, Müller M, Falla D et al (2017) Clinical relevance of persistent postoperative pain after total hip replacement – a prospective observational cohort study. J Pain Res 10:2183–2193. https://doi.org/10.2147/JPR.S137892 CrossRefPubMedPubMedCentral

10.

van der Wees PJ, Wammes JJ, Akkermans RP et al (2017) Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital Setting: results of twenty years clinical registry. BMC Musculoskelet Disord 18:97. https://doi.org/10.1186/s12891-017-1455-y CrossRefPubMedPubMedCentral

11.

Lindner M, Nosseir O, Keller-Pliessnig A et al (2018) Psychosocial predictors for outcome after total joint arthroplasty: a prospective comparison of hip and knee arthroplasty. BMC Musculoskelet Disord 19:159. https://doi.org/10.1186/s12891-018-2058-y CrossRefPubMedPubMedCentral

12.

Hamilton D, Henderson GR, Gaston P et al (2012) Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study. Postgrad Med J 88:627–631. https://doi.org/10.1136/postgradmedj-2011-130715 CrossRefPubMed

13.

Liebensteiner M, Wurm A, Gamper D, Oberaigner W, Dammerer D, Krismer M (2019) Patient satisfaction after total knee arthroplasty is better in patients with pre-operative complete joint space collapse. Int Orthop 43:1841–1847. https://doi.org/10.1007/s00264-018-4185-3 CrossRefPubMed

14.

Ethgen O, Bruyère O, Richy F et al (2004) Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 86:963–974. https://doi.org/10.2106/00004623-200405000-00012 CrossRefPubMed

15.

Beswick AD, Wylde V, Gooberman-Hill R et al (2012) What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2:e000435. https://doi.org/10.1136/bmjopen-2011-000435 CrossRefPubMedPubMedCentral

16.

Hassett AL, Marshall E, Bailey AM et al (2018) Changes in anxiety and depression are mediated by changes in pain severity in patients undergoing lower-extremity total joint arthroplasty. Reg Anesth Pain Med 43:14–18. https://doi.org/10.1097/AAP.0000000000000682 CrossRefPubMedPubMedCentral

17.

Ramaesh R, Jenkins P, Macdonald D et al (2014) Personality, function and satisfaction in patients undergoing total hip or knee replacement. J Orthop Sci 19:275–281. https://doi.org/10.1007/s00776-013-0509-8 CrossRefPubMed

18.

Benditz A, Jansen P, Schaible J et al (2017) Psychological factors as risk factors for poor hip function after total hip arthroplasty. Ther Clin Risk Manag 13:237–244. https://doi.org/10.2147/TCRM.S127868 CrossRefPubMedPubMedCentral

19.

Badura-Brzoza K, Zajac P, Brzoza Z et al (2009) Psychological and psychiatric factors related to health-related quality of life after total hip replacement - preliminary report. Eur Psychiatry 24:119–124. https://doi.org/10.1016/j.eurpsy.2008.06.009 CrossRefPubMed

20.

Gustin SM, Burke LA, Peck CC et al (2016) Pain and personality: do individuals with different forms of chronic pain exhibit a mutual personality? Pain Pract 16:486–494. https://doi.org/10.1111/papr.12297 CrossRefPubMed

21.

Naylor B, Boag S, Gustin SM (2017) New evidence for a pain personality? A critical review of the last 120 years of pain and personality. Scand J Pain 17:58–67. https://doi.org/10.1016/j.sjpain.2017.07.011 CrossRefPubMed

22.

Nahman-Averbuch H, Yarnitsky D, Sprecher E et al (2016) Relationship between personality traits and endogenous analgesia: the role of harm avoidance. Pain Pract 16:38–45. https://doi.org/10.1111/papr.12256 CrossRefPubMed

23.

Burns LC, Ritvo SE, Ferguson MK et al (2015) Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review. J Pain Res 8:21–32. https://doi.org/10.2147/JPR.S64730 CrossRefPubMedPubMedCentral

24.

Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85:317–332CrossRef

25.

Halvorsen M, Wang CE, Richter J et al Early maladaptive schemas, temperament and character traits in clinically depressed and previously depressed subjects. Clin Psychol Psychother 16:394–407. https://doi.org/10.1002/cpp.618

26.

Desmeules F, Dionne CE, Belzile ÉL et al (2013) Determinants of pain, functional limitations and health-related quality of life six months after total knee arthroplasty: results from a prospective cohort study. BMC Sports Sci Med Rehabil 5:2. https://doi.org/10.1186/2052-1847-5-2 CrossRefPubMedPubMedCentral

27.

Núñez-Cortés R, Chamorro C, Ortega-Palavecinos M, Mattar G, Paredes O, Besoaín-Saldaña Á, Cruz-Montecinos C (2019) Social determinants associated to chronic pain after total knee arthroplasty. Int Orthop 43:2767–2771. https://doi.org/10.1007/s00264-019-04370-6 CrossRefPubMed

Titel: Personality traits predict residual pain after total hip and knee arthroplasty
verfasst von: Michele Mercurio
Giorgio Gasparini
Elvira Anna Carbone
Olimpio Galasso
Cristina Segura-Garcia
Publikationsdatum: 03.04.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 7/2020
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04553-6

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Abstract

Aim of the study

Method

Results

Discussion

Conclusion

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