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.

中文翻译：

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人格特质预测髋关节和膝关节置换术后残留的疼痛。

研究目的

我们评估了人格特质，焦虑和抑郁在接受全髋关节（THA）和膝关节（TKA）置换术的患者残留疼痛中的作用。

方法

术前接受了83例患者（40 THA和43 TKA）的访问（t ₀）；手术后五天（t ₁）；手术后分别为（t ₂），3（t ₃），6（t ₄）和12个月（t ₅）。评估了人格（TCI-R），疼痛（VAS），焦虑和抑郁（HADS），生活质量（SF-12），功能（HHS / KSS）和残疾（WOMAC）。

结果

据报道， THA和TKA患者在t _5时疼痛减轻和功能改善（均p <0.001）。 与TKA相比，THA患者在手术后表现出更早，更大的功能改善（均p <0.001）。在15％的THA患者和25％的TKA患者中发现了残余疼痛（VAS> 30 mm），并且与SF-12 PCS相关（r ²  = − 0.412; p  <0.001），SF-12 MCS （r ²  =  − 0.473; p  <0.001），HADS-A（r ²  = 0.619; p  = <0.001），HADS-D（r ²  = 0.559; p <0.001），功能性（r ²  =-0.482; p  <0.001）和WOMAC（r ²  = 0.536; p  <0.001）在t ₅得分。术前避免，持续性和焦虑评分高是THA和TKA后残余疼痛的预测指标（p  <0.001）。

讨论区

这项研究中抱怨残留疼痛的患者比例与以前的发现相似。先前已经描述了THA和TKA后残余疼痛的多种预测因素，并且多项研究评估了心理因素对关节置换术结果的影响。然而，只有四项研究调查了人格特质在THA和TKA患者预后中的作用，而这些研究中的一项独特研究证明了人格特效对持续性疼痛的影响。

结论

目前的研究表明，人格特质和焦虑可以预测残余疼痛。因此，对这些因素进行术前评估可能有助于确定有残留疼痛风险的患者。