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Abstract：
Pain catastrophizing is an exaggerated focus on pain sensations. It may be an independent factor influencing pain and functional outcomes of knee arthroplasty. We aimed to evaluate the association between pre-operative pain catastrophizing with pain and function outcomes up to one year after knee arthroplasty. We used data from a cohort study of patients undergoing primary knee arthroplasty (either total or unicompartmental arthroplasty) for knee osteoarthritis. Pain catastrophizing was assessed pre-operatively using the Pain Catastrophizing scale (PCS). Other baseline variables included demographics, body mass index, radiographic severity, anxiety, depression, and knee pain and function assessed using the Western Ontario and McMaster University Index (WOMAC). Patients completed the WOMAC at 6- and 12-months after arthroplasty. WOMAC pain and function scores were converted to interval scale and the association of PCS and changes of WOMAC pain and function were evaluated in generalized linear regression models with adjustment with confounding variables. Of the 1136 patients who underwent arthroplasty (70% female, 84% Chinese, 92% total knee arthroplasty), 1102 and 1089 provided data at 6- and 12-months post-operatively. Mean (± SD) age of patients was 65.9 (± 7.0) years. PCS was associated with a change in WOMAC pain at both 6-months and 12-months (β = - 0.04, 95% confidence interval: - 0.06, - 0.02; P < 0.001) post-operatively after adjustment in multivariable models; as well as change in WOMAC function at 6-months and 12-months. In this large cohort study, pre-operative pain catastrophizing was associated with lower improvements in pain and function at 6-months and 12-months after arthroplasty.
摘要：
疼痛灾难化是对疼痛感觉的夸大关注。它可能是影响膝关节置换术疼痛和功能结局的独立因素。我们旨在评估膝关节置换术后长达一年的术前疼痛灾难与疼痛和功能结局之间的关系。我们使用了一项队列研究的数据，该研究对接受膝关节骨关节炎初次膝关节置换术（完全或单室关节置换术）的患者进行了研究。术前使用疼痛灾变量表（PCS）评估疼痛灾变。其他基线变量包括人口统计，身体质量指数,射线照相严重性，焦虑,抑郁症,使用西安大略省和麦克马斯特大学指数（WOMAC）评估膝关节疼痛和功能。患者在关节置换术后6个月和12个月完成了WOMAC。将WOMAC疼痛和功能评分转换为间隔量表，并在广义线性回归模型中评估PCS与WOMAC疼痛和功能变化的关联，并调整混杂变量。在1136例接受关节置换术的患者中（70％为女性，84%中国人，92%全膝关节置换术)，1102和1089提供了术后6个月和12个月的数据。患者的平均（±SD）年龄为65.9（±7.0）岁。在多变量模型调整后，PCS与术后6个月和12个月WOMAC疼痛的变化相关（β=-0.04，95％置信区间：-0.06，-0.02；P<0.001）；以及6个月和12个月WOMAC功能的变化。在这项大型队列研究中，术前疼痛灾难化与关节置换术后6个月和12个月疼痛和功能改善较低相关.
