PRESENTER: Zina Trost
Abstract Proof
TITLE: Predicting Pain Catastrophizing following Total Knee Arthroplasty
AUTHORS (FIRST NAME, LAST NAME): Zina Trost, Johanna Harrison, Nils Niederstrasser,
Whitney Scott, Michael J. Sullivan
Abstract Body: Pain catastrophizing has been identified as an important predictor of disability
among individuals with various pain conditions, including people with osteoarthritis (OA) of the
knee. Total Knee Arthroplasty (TKA) is the most popular treatment to reduce OA-associated knee
pain. Patients with elevated levels of catastrophizing are at particular risk for problematic
outcomes following TKA. However, no research has yet examined which variables impact
patients’ catastrophizing following TKA intervention. Accordingly, the current study examined
predictors of post-surgical pain catastrophizing (measured by Pain Catastrophizing Scale) among
112 patients with OA (47 men, 65 women, mean age 66.9 yrs) undergoing TKA. Prior to TKA,
participants completed measures of pain catastrophizing, depression, and pain self-efficacy, and
rated a number of pain variables (pain intensity, stiffness, and functional interference). Patients
completed the same measures at three months following surgery. Repeated-measures analyses
confirmed significant reduction in patients’ pain catastrophizing, as well as significant
improvement on measures of depression, self-efficacy, and pain. Stepwise regression analyses
controlling for demographic characteristics and initial pain catastrophizing indicated that changes
in psychosocial variables (depression and self-efficacy) predicted comparable or greater unique
variance in pain catastrophizing following surgery in comparison to changes in pain variables.
Importantly, participants’ initial level of pain catastrophizing remained most predictive of their pain
catastrophizing following surgery, accounting for approximately 40% of the variance. These
results reinforce the importance of psychosocial variables in surgical recovery and rehabilitation,
and suggest that catastrophizing may be a stable variable that is not entirely dependent on
change in pain status. Findings are discussed in terms of their theoretical significance as well as
implications for pre- and post- surgical interventions.