(376) An Evaluation of the Short- and Long-Term Influence of Presurgical Expectancies on Pain and Function following Total Knee Arthroplasty

Abstract

Expectancies have a strong, well-documented influence on future pain experiences, responses to pain, pain treatment outcomes, and postsurgical outcomes. In individuals with osteoarthritis, several studies haveshown that presurgical expectancies predict heightened pain and disability following total knee arthroplasty. However, despite growing recognition of the importance of expectancies in clinical settings, evidence to support the short and long-term predictive nature of expectancies is unsatisfactory. The objective of the present study was to explore the temporal association between presurgical expectancies and pain and function following total knee arthroplasty. Data were collected from patients scheduled for total knee arthroplasty 1 week prior to surgery, and then at 6 weeks, 3 months, 6 months, and 1-year post-surgery. Multivariate analyses examined the influence of presurgical expectancies on patients’ perceptions of pain reductions and functional improvements at each time-point. All analyses controlled for age, sex, presurgical pain intensity, pain catastrophizing, depression and anxiety. Results revealed that pain expectancies significantly predicted reductions in pain at 3-month and 1-year follow-ups, however pain expectancies were better predictors of pain at 1-year follow-up than at 3-month follow-up. Functional expectancies significantly predicted improvements in function at 1-year follow-up, but not at any of the other time-points. This study extends previous work by investigating the effect of presurgical expectancies on pain outcomes over time. It identifies expectancies as important predictors of long-term postsurgical pain and function, providing targets for clinical interventions. The results of this study highlight the importance of measuring associations between expectancies and pain outcomes at multiple time-points to fully capture the relationship between expectancies, pain and function following total knee arthroplasty.