Effects of empowered relief on pain catastrophizing and outcomes post-total knee arthroplasty: A quasi-experimental study.

Background

Total knee arthroplasty (TKA) is the most effective surgical method for end-stage knee joint diseases, yet chronic postoperative pain related to pain catastrophisation remains a major cause of patient dissatisfaction, warranting evaluation of Empowered Relief (ER) in TKA patients.

Objective

This quasi-experimental study evaluated digital ER's effectiveness in reducing pain catastrophizing post-TKA.

Methods

This quasi-experimental study enrolled 70 primary unilateral TKA patients at a tertiary hospital in Lanzhou, China (March-June 2023). Participants were allocated by admission date: the intervention group (March-April, 35) received enhanced recovery protocols with standard pain management, while the control group (May-June, 35) received standard management alone. Pain outcomes were assessed at postoperative weeks 2 (1), 1 month (2), and 3 months (3) using validated tools: Pain Catastrophizing Scale (PCS), Numerical Rating Scale (NRS), and APS-POQ-C (Chinese version) to evaluate catastrophisation, intensity, and management efficacy. Generalized Estimating Equations (GEEs) were employed for longitudinal statistical analysis.

Results

The ER program showed statistically significant main effects across groups ( ), temporal effects ( ¡ 0.001), and group-time interaction effects ( ) on pain catastrophisation scores, pain intensity scores, and pain management outcomes, respectively. And as time went on, the intervention group showed greater improvement than the control group in pain catastrophizing (PCS:1 16,2 9,3 5 versus 1 29,2 23,3 19.5), pain intensity (Pain: 1 4,2 2.5,3 1 versus 1 4,2 3,3 2) and pain management outcomes (APS-POQ-C: 1 12.125,2 3.875,3 1.25 versus 1 15.75,2 9.5,3 5).

Conclusions

The ER program significantly reduced postoperative pain intensity and catastrophisation in TKA patients, enhancing pain management outcomes compared to conventional therapies. Its concentrated 2 h format demonstrates promising efficacy over standard care, offering a streamlined alternative to traditional postoperative regimens.

Keywords

Total knee arthroplasty, intervention efficacy, pain catastrophisation, psychotherapy

Conflict of interest statement

The authors declare that there is no conflict of interest in this research.