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 .
The role of presurgical expectancies in predicting pain and function one year following total knee arthroplasty
Summary Patients ’ behavioral outcome expectancies assessed presurgically predicted pain severity and physical function 1 year after total knee arthroplasty ( TKA ) and partially mediated the relation between catastrophizing and TKA outcomes . Abstract The present study examined the prospect i ve value of response expectancies ( ie , pain , sleep ) and behavioral outcome expectancies ( ie , return to function ) in the prediction of pain severity and functional limitations 12 months after total knee arthroplasty ( TKA ) . The study sample consisted of 120 individuals ( 73 women , 47 men ) with osteoarthritis of the knee who were scheduled for TKA .  Measures of expectancies , pain severity , pain catastrophizing , pain‐related fears of movement , and depression  were completed prior to surgery . Participants also completed measures of pain severity and functional limitations 12 months following surgery . Analyses revealed that behavioral outcome expectancies were stronger predictors of follow‐up pain and functional limitations than response expectancies . Consistent with previous research , analyses also revealed that pain catastrophizing , pain‐related fear of movement , and depression predicted follow‐up pain and function . In a multivariate analysis , only pain catastrophizing contributed significant unique variance to the prediction of follow‐up pain and function . Behavioral outcome expectancies partially mediated the relation between catastrophizing and follow‐up pain and function . The relation between catastrophizing and follow‐up pain severity and functional limitations remained significant even when controlling for behavioral outcome expectancies . The results suggest that interventions design ed to specifically target behavioral outcome expectancies and catastrophizing might improve post‐surgical 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 .