You are here

  • Home
  • Archive
  • Volume 9, Issue 12
  • Effectiveness and reporting standards of psychological interventions for improving short-term and long-term pain outcomes after total knee replacement: a systematic review

Article Text

Article menu

Download PDFPDF

XML
Surgery
Original research
Effectiveness and reporting standards of psychological interventions for improving short-term and long-term pain outcomes after total knee replacement: a systematic review
  1. Katie Whale1,2,
  2. Vikki Wylde1,2,
  3. Andrew Beswick2,
  4. James Rathbone3,4,
  5. Kavita Vedhara3,
  6. Rachael Gooberman-Hill1,2
  1. 1 National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
  2. 2 Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  3. 3 Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
  4. 4 Pain Centre Versus Arthritis, City Hospital, University of Nottingham, Nottingham, United Kingdom
  1. Correspondence to DrKatieWhale; katie.whale{at}bristol.ac.uk

Abstract

Objectives To assess the effectiveness and reporting standards of psychological interventions for improving outcomes after total knee replacement (TKR).

Design Medline, Embase, and PsycINFO were searched from inception to up to 9 May 2019 with no language restrictions applied. Randomised controlled trials (RCTs) assessing the effectiveness of psychological interventions for short-term and long-term postoperative pain after TKR were included. Screening, data extraction, and assessment of methodological quality were performed in duplicate by two reviewers. The primary effectiveness outcome was postoperative pain severity and the primary harm outcome was serious adverse events. Secondary outcomes included function, quality of life, and psychological well-being. Reporting standards were assessed using the Template for Intervention Description and Replication (TIDieR) checklist for intervention reporting.

Results 12 RCTs were included, with a total of 1299 participants. Psychological interventions comprised music therapy (five studies), guided imagery and music (one study), hypnosis (one study), progressive muscle relaxation with biofeedback (one study), pain coping skills programme (one study), cognitive–behavioural therapy (two studies), and a postoperative management programme (one study). Due to the high heterogeneity of interventions and poor reporting of harms data, it was not possible to make any definitive statements about the overall effectiveness or safety of psychology interventions for pain outcomes after TKR.

Conclusion Further evidence about the effectiveness of psychological interventions for improving pain outcomes after TKR is needed. The reporting of harm outcomes and intervention fidelity is currently poor and could be improved. Future work exploring the impact of intervention timing on effectiveness and whether different psychological approaches are needed to address acute postoperative pain and chronic postoperative pain would be of benefit.

PROSPERO registration number CRD42018095100.

  • musculoskeletal
  • psychological
  • intervention
  • knee replacement
  • systematic review

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-029742

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @whalekatie

    • Contributors KW: lead author, protocol writing, data searches, data screening, data extraction, manuscript writing and preparation VW: protocol writing, data screening, data extraction and manuscript writing. AB: protocol writing, data searches, methodological design and manuscript review. JR: data extraction and manuscript review. KV: study inclusion review and manuscript review. RG-H: protocol writing and manuscript review.

    • Funding This study was supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, and the NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust.

    • Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.