Abstract
Aim: The aim of this study was to investigate how psychological factors and illness perception can influence the recovery and functional outcome after total knee arthroplasty (TKA).
Patients and Methods: 100 patients who underwent primary total knee arthroplasty were included in this study. Pre-operatively patients were asked to complete a psychological questionnaire consisting of the revised Illness Perception Questionnaire (IPQ-r), Hospital Anxiety and Depression scale (HADS) and Recovery Locus of Control scale (RLOC). Function was assessed using Oxford Knee Score (OKS) and range of motion (ROM) pre-operatively and at six weeks and one year after surgery.
Results: Early results show that individual phychological variables correlate with the post-operative OKS at six weeks. Beliefs that the condition has a major effect on life and less understanding of the illness are associated with a poorer recovery. Women were found to have a higher degree of personal control, but this was not correlated with functional outcome. Patients with higher pre-operative OKS were more likely to suffer from anxiety and depression.
None of the investigated parameters predicted ROM at six weeks.
Discussion: Recovery from TKA surgery can be difficult to predict. This study showed that several psychological variables influence early functional outcome. These should be taken into account when considering patients for TKA surgery. Improving patient education, looking at home environment and social network as well as adressing anxiety and depression may help to improve overall outcome after TKA surgery.
Correspondence should be addressed to Mr T Wilton, c/o BOA, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
