Effect of a Patient Education in Pain Coping for Patients Scheduled for Total Knee Arthroplasty
- Conditions
- Knee Osteoarthritis
- Interventions
- Behavioral: Patient education
- Registration Number
- NCT02587429
- Lead Sponsor
- Regional Hospital West Jutland
- Brief Summary
The aim of this study is to investigate, whether a patient education with focus on pain coping is able to improve physical function and experienced pain level in patients with high levels of pain catastrophizing before Total Knee Arthroplasty. Resent studies indicates that these patients do not achieve a satisfactory pain relief and physical function after TKA. Furthermore, the aim is to determine if there is a difference in physical activity and muscle mass among patients with high levels of pain catastrophizing compared to patients with low levels of pain catastrophizing.
- Detailed Description
In Denmark, are approximately 8000 patients operated annually with Knee Arthroplasty. Most of these patients will have less pain and higher functional ability after the surgery. However, some patients respond poorly to the surgery and approximately 20% of the patients report persistent function-limiting pain six months or more following a total knee arthroplasty (TKA).
Research has shown that patients with high pain catastrophizing scores are at higher risk of having persistent pain and lower physical function after the operation.
This study consists of two parts. The first part is a randomised controlled trial where 56 patients with high levels of pain catastrophizing before TKA are randomised to either treatment as usual (control group 1), which implies surgery and the standard postoperative rehabilitation, or in addition to this, a patient education focusing on pain behaviour and pain coping (patient education). In the second part the patients in control group 1 will be matched on age, BMI and gender with additionally 28 patients with a low levels of pain catastrophizing (control group 2).
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 84
- Age above 18 years
- Inability to understand and communicate with the investigators
- Scheduled for an elective unilateral total knee arthroplasty
- Primary diagnosis of osteoarthritis
- Score greater than 22 or lower than 12 on the Pain Catastrophizing Scale (PCS)
- Planned to undergo another elective joint replacement procedure during the 12 months period of participation
- Scheduled for revision arthroplasty surgery
- TKA surgery scheduled because of fracture, malignancy or infection
- Scheduled for Unicompartmental knee arthroplasty
- Major depression diagnosed with the Major Depression Index (MDI)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Patienteducation Patient education (Patients with PCS\>22). An education in pain coping delivered by physiotherapists. The education consist of seven sessions over a four months period. Each session is individual and will last 30 minutes. Focus will be on pain behaviour and pain coping based on Cognitive Behavioral Therapy.
- Primary Outcome Measures
Name Time Method Pain measured on a Visual Analog Scale (0-100) 12 months
- Secondary Outcome Measures
Name Time Method Tri-axial-accelerometer 12 months To measure physical activity for seven days
Six-minute Walk Test 12 months Sit-to-stand in 30 seconds 12 months Dual Energy X-ray Absorptiometry (DXA) scan 12 months To detect muscle mass
Short Form 36 (Physical Function) 12 months Pain Self-Efficacy Questionnaire (PSEQ) 12 months EuroQol (EQ-5D) 12 months Pain Catastrophizing Scale 12 months Knee injury and Osteoarthritis Outcome Score (KOOS) 12 months Oxford Knee Score 12 months
Trial Locations
- Locations (1)
Regional Hospital Holstebro
🇩🇰Holstebro, Denmark