Sleep disturbance, anxiety, depression and catastrophizing about pain can contribute to lingering pain after total knee arthroplasty (TKA), according to a prospective study out of the University of Pittsburgh. The study consisted of 153 white adult patients (average age, 64 years; 58% women). All patients underwent unilateral TKA at the University of Pittsburgh Medical Center. Before surgery, patients had a clinical evaluation and completed five self-report psychosocial questionnaires. At baseline, 88 percent of patients reported moderate to severe pain related to their osteoarthritis, which was reduced to 24 percent at six months. The strongest association between psychological traits and chronic/severe pain six months after surgery was for sleep disturbance, followed by perceived stress and somatization.
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