This study provides moderate-level evidence for pain catastrophizing as an independent predictor of chronic pain post-TKA .
BACKGROUND Total knee arthroplasty ( TKA ) is a common and costly surgical procedure .
Despite high success rates , many TKA patients develop chronic pain  in the months and years following surgery , constituting a public health burden .
Pain catastrophizing is a construct that reflects anxious preoccupation with pain , inability to inhibit pain-related fears , amplification of the significance of pain vis-à-vis health implication s , and a sense of helplessness regarding pain .
Recent research suggests that it may be an important risk factor for untoward TKA outcomes .
To clarify this impact , we systematic ally review ed the literature to date on pain catastrophizing as a prospect i ve predictor of chronic pain following TKA .
Predicting Total Knee Replacement Pain: A Prospective, Observational Study
To describe the natural history of pain after total knee arthroplasty and to identify factors predicting excessive postoperative pain , we used a prospect i ve , observational study assessing clinical and radiographic variables preoperatively and at 1 , 3 , 6 , and 12 months after knee replacement .  Data sources included the visual analog pain scale and other measures of patient health , psychologic state , and component reliability . Regression analyses were conducted to identify specific factors predictive of postoperative pain , controlling for ine quality of variables , and confirmed using regression diagnostics . For 116 patients ( 149 knees ; mean age , 66 years ; 55.2 % women ) , significant pain was reported by 72.3 % , 44.4 % , 22.6 % , 18.4 % , and 13.1 % , respectively . No intergroup differences existed for anesthesia , weight , age , or gender . Patients with greater preoperative pain had more postoperative pain , used more home therapy , and postoperative manipulations . Preoperative depression and anxiety were associated with heightened pain at 1 year . Pain after knee replacement resolves quickly , declining to approximately 1/2 by 3 months . However , one in eight patients report moderate to severe pain 1 year after surgery despite an absence of clinical or radiographic abnormalities . Development of office-based preoperative screening tools and interventions for these patients may reduce postoperative costs and improve patient-perceived outcomes
This study provides moderate-level evidence for pain catastrophizing as an independent predictor of chronic pain post-TKA .
BACKGROUND Total knee arthroplasty ( TKA ) is a common and costly surgical procedure .
Despite high success rates , many TKA patients develop chronic pain  in the months and years following surgery , constituting a public health burden .
Pain catastrophizing is a construct that reflects anxious preoccupation with pain , inability to inhibit pain-related fears , amplification of the significance of pain vis-à-vis health implication s , and a sense of helplessness regarding pain .
Recent research suggests that it may be an important risk factor for untoward TKA outcomes .
To clarify this impact , we systematic ally review ed the literature to date on pain catastrophizing as a prospect i ve predictor of chronic pain following TKA .