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 .
Prospective relation between catastrophizing and residual pain following knee arthroplasty: two-year follow-up.
BACKGROUND Pain is the primary indication for both primary and revision total knee arthroplasty ( TKA ) ; however , most arthroplasty outcome measures do not take pain into account . OBJECTIVE To document the prospect i ve pain experience following TKA , with subjective pain-specific question naires to determine if comorbidities , preoperative pain or preoperative pain catastrophizing scores are predictive of long-term pain outcomes . METHODS Fifty-five patients with a primary diagnosis of osteoarthritis of the knee , who were scheduled to undergo TKA , were asked to fill out the McGill Pain Question naire ( MPQ ) and the Pain Catastrophizing Scale ( PCS ) preoperatively and at three , 12 and 24 months follow-up . Comorbidities were extracted from the Queen Elizabeth II Health Sciences Centre health information system . RESULTS The overall response rate ( return of completed question naires ) was 84 % . There was a significant decrease in the MPQ scores ( P<0.05 ) postoperatively . PCS scores did not change over time . Receiver operating characteristic curves revealed the number of comorbidities per patient predicted the presence of pain postoperatively , as documented by the numerical rating subscale of the MPQ at 24 months ( P<0.05 ) . Receiver operating characteristic curves for preoperative PCS and rumination subscale scores predicted the presence of pain , as measured by the Pain Rating Index subscale of the MPQ at 24 months ( P<0.05 ) . Preoperative PCS scores and comorbidities were significantly higher in the persistent pain group ( P<0.05 ) . CONCLUSIONS The number of comorbidities predicted the presence of pain at 24 months follow-up and , for the first time , preoperative PCS scores were shown to predict chronic postoperative pain . This may enable the identification of knee arthroplasty patients at risk for persistent postoperative pain , thus allowing for efficient administration of preoperative interventions to improve arthroplasty 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 .