The influence of perioperative interventions targeting psychological distress on clinical outcome after total knee arthr
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Rheumatology International https://doi.org/10.1007/s00296-020-04644-y
INTERNATIONAL
SYSTEMATIC REVIEW
The influence of perioperative interventions targeting psychological distress on clinical outcome after total knee arthroplasty Juliette Caroline Sorel1,2,6 · Geke Marianne Overvliet3 · Maaike Gerarda Johanna Gademan1,4 · Chantal den Haan5 · Adriaan Honig3 · Rudolf Wilhelm Poolman1,2,6 Received: 18 April 2020 / Accepted: 3 July 2020 © The Author(s) 2020
Abstract Our aim was to assess the effect of perioperative interventions targeting psychological distress on clinical outcome after total knee arthroplasty (TKA). We searched studies on the effect of perioperative interventions focused on psychological distress used in conjunction with TKA on pain, function, and quality of life (QoL) on PubMed, Embase.com, PsycINFO/ OVID, CENTRAL, the Cochrane Database of Systematic Reviews, Scopus, and Web of Science. We included 40 studies (22 RCTs, ten cohort studies, and eight quasi-experimental studies) with a total of 3846 patients. We graded the quality of evidence as low for pain and function and as moderate for QoL. Patients receiving music, education, cognitive behavioural therapy, guided imagery, pain coping skills training, Reiki, occupational therapy with self-monitoring, and biofeedbackassisted progressive muscles relaxing training had lower pain scores or declined opioid prescriptions after TKA. Pain coping skills training, audio recording-guided imagery scripts, video promoting self-confidence, psychological therapies by video, Reiki, music, occupational therapy with self-monitoring, education, and psychotherapy improved postoperative functional outcome. Education through an app improved QoL after TKA. The studies in our systematic review show that perioperative interventions targeting psychological distress for patients receiving TKA seem to have a positive effect on postoperative pain, function, and QoL. RCTs with strict methodological safeguards are still needed to determine if perioperative interventions focused on psychological distress should be used in conjunction with TKA. These studies should also assess which type of intervention will be most effective in improving patient-reported outcome measures and declining opioid prescriptions. Keywords Total knee arthroplasty · Psychological distress · Pain · Function · Quality of life Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00296-020-04644-y) contains supplementary material, which is available to authorized users. * Juliette Caroline Sorel [email protected] 1
Department of Orthopaedics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
2
Department of Orthopaedic Surgery and Traumatology, Joint Research OLVG, 1091 AC Amsterdam, The Netherlands
3
Department of Psychiatry, OLVG, Amsterdam and Amsterdam UMC, Jan Tooropstraat 164, 1105 AZ Amsterdam, The Netherlands
4
Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Neth
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