Personality traits predict residual pain after total hip and knee arthroplasty

Michele Mercurio; Giorgio Gasparini; Elvira Anna Carbone; Olimpio Galasso; Cristina Segura-Garcia

doi:10.1007/s00264-020-04553-6

Personality traits predict residual pain after total hip and knee arthroplasty

Int Orthop. 2020 Jul;44(7):1263-1270. doi: 10.1007/s00264-020-04553-6. Epub 2020 Apr 3.

Authors

Michele Mercurio¹, Giorgio Gasparini², Elvira Anna Carbone³, Olimpio Galasso¹, Cristina Segura-Garcia⁴

Affiliations

¹ Department of Orthopaedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa, (loc. Germaneto), 88100, Catanzaro, Italy.
² Department of Orthopaedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa, (loc. Germaneto), 88100, Catanzaro, Italy. gasparini@unicz.it.
³ Psychiatric Unit, Department of Health Sciences, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa, (loc. Germaneto), 88100, Catanzaro, Italy.
⁴ Psychiatric Unit, Department of Medical and Surgical Sciences, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa, (loc. Germaneto), 88100, Catanzaro, Italy.

PMID: 32246164
DOI: 10.1007/s00264-020-04553-6

Abstract

Aim of the study: We assessed the role of personality traits, anxiety, and depression in residual pain among patients who underwent total hip (THA) and knee (TKA) arthroplasty.

Method: Eighty-three patients (40 THA and 43 TKA) were interviewed pre-operatively (t₀); five days (t₁) after surgery; and one (t₂), three (t₃), six (t₄), and 12 months (t₅) after surgery. Personality (TCI-R), pain (VAS), anxiety and depression (HADS), quality of life (SF-12), functionality (HHS/KSS), and disability (WOMAC) were evaluated.

Results: Pain reduction and functional improvement were reported at t₅ (both p < 0.001) in both THA and TKA patients. THA patients showed earlier and greater functional improvement after surgery (both p < 0.001) in comparison with TKA. Residual pain (VAS > 30 mm) was noted in 15% of the THA patients and 25% of the TKA patients, and it correlated with the SF-12 PCS (r² = - 0.412; p < 0.001), SF-12 MCS (r² = - 0.473; p < 0.001), HADS-A (r² = 0.619; p = <0.001), HADS-D (r² = 0.559; p < 0.001), functionality (r² = - 0.482; p < 0.001), and WOMAC (r² = 0.536; p < 0.001) scores at t₅. High pre-operative harm avoidance, persistence, and anxiety scores were predictive of residual pain after both THA and TKA (p < 0.001).

Discussion: The proportion of patients complaining of residual pain in this study was similar to that in previous findings. Multiple predictors of residual pain after THA and TKA have been previously described, and several studies evaluated the influence of psychological factors on the outcome of joint arthroplasty; however, only four studies investigated the role of personality traits in the outcome of THA and TKA patients, and a unique study out of these investigations demonstrated the effect of personality on persisting pain.

Conclusion: The current study demonstrated that personality traits and anxiety predict residual pain; thus, pre-operative evaluation of these factors could be helpful in identifying patients at risk for residual pain.

Keywords: Anxiety; Depression; Personality traits; Residual pain; Total hip arthroplasty; Total knee arthroplasty.

MeSH terms

Arthroplasty, Replacement, Hip* / adverse effects
Arthroplasty, Replacement, Knee* / adverse effects
Humans
Pain
Personality
Quality of Life
Treatment Outcome