Pain Expectations Affect Postoperative Reactions

Providing patients with more realistic expectations about chronic pain following total knee arthroplasty (TKA), may improve the pain experience post-surgery, according to a presentation given at the 2010 European Federation, as reported by Ortho SuperSite.

The presentation was performed by researchers from the United Kingdom.

Previous research demonstrates that 6-30% of patients report chronic pain in the replaced joint following TKA.

“The occurrence of chronic pain following surgery is an important issue to consider as it has been associated with poorer quality of life, increased distress and elevated levels of depression,” Alison Jeffery said during her presentation at the 2010 European Federation of National Associations of Orthopaedics and Traumatology (EFORT) Congress in Madrid. “While there has been much research into chronic pain in the context of other conditions, little research has explored patients’ experiences of chronic pain after joint replacement.”

Jeffrey and colleagues performed a study that investigated the experience of postoperative chronic pain from the patient’s perspective. The study included 28 TKA patients that reported chronic pain in the replaced joint at least one year postoperatively and required the use of pain medication. In-depth interviews were conducted that explored the patients’ perceptions of their condition, its cause, duration, consequences, and their sense of control.

Some were found to be well-adjusted and accepted their pain. Others reported ongoing distress as a result of the pain. The level of distress described did not relate to intensity of pain.

The team concluded that a patient’s cognitions, beliefs and expectations affected the ability to adjust to chronic pain following TKA.