The effect of personality on recovery from total hip replacement and total knee replacement in patients with osteoarthritis

• Main Author: Gibson, Clare Naomi
• Published: University of Sheffield 2007
• Subjects: 155
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486714

Background: Total hip replacement (THR) and total knee replacement (TKR) are increasingly common procedures to treat the pain and disability associated with osteoarthritis. There is a large variability in time to achieve functional milestones following these procedures and of success of surgery measured by pain and functional ability. Factors which affect outcome are poorly understood, but research in health psychology suggests psychological variables may play an important role. Objectives: To explore the relationships between selected psychological variables with pain and function pre-operatively in patients awaiting THR and TKR, on achievement of key functional milestones as an inpatient post-operatively, and of pain and function three-months post-operatively. Design: A correlational study of patients undergoing primary unilateral THR and TKR as a result of osteoarthritis. Subjects: 105 THR, 70 TKR. Psychological Measures: NEO-Five Factor Inventory, Multi-dimensional Health Locus of Control Questionnaire, Coping Strategies Questionnaire. Outcome Measures: Oxford Hip Score, Harris Hip Score, Oxford Knee Score, Knee Society Knee Score, key functional physiotherapy milestones. Results: Hip Study: Catastrophizing was a significant predictor of greater pain and worse function both pre-and post-operatively. Pain control efficacy was predictive of less pain and better function pre- and post-operatively. In addition, conscientiousness was a predictor of worse pre-operative function. Few psychological variables were predictive of physiotherapy outcome measures. Knee Study: Neuroticism was found to be a predictor of worse pain both pre- and post- operatively. Pre-operatively openness to experience was predictive of less pain and better function. Post-operatively, a chance locus of control was predictive of worse functioning. Few psychological variables were predictive of physiotherapy outcome measures. Conclusions: Psychological variables influence pain and function both pre- and post- operatively in THR and TKR. The psychological variables may exert their actions through pain control efficacy. There is scope to develop an intervention targeting negative psychological variables and improve outcome.