Long term biopsychosocial outcomes and their associations after total knee arthroplasty in individuals with knee osteoarthritis
摘要
Total knee arthroplasty (TKA) is a common intervention for individuals with knee osteoarthritis (OA) aimed at reducing pain and improving function. However, recovery extends beyond surgical outcomes, involving complex interactions among physical, psychological, and social factors. This study evaluated long-term postoperative outcomes including pain, function, quality of life (QoL), and psychological status in individuals with knee OA from a biopsychosocial perspective. A cross-sectional study was conducted among patients aged 50–80 years who underwent TKA between January 2017 and December 2022 at a tertiary care hospital. Demographic and clinical information was obtained from hospital records, and patient-reported outcomes including pain, function, disease-specific and general QoL, and psychological measures were collected via telephone. Descriptive statistics and correlation analyses were performed. Of 810 eligible patients, 492 responded. While 80.4% reported satisfaction postsurgery, only 28% attended long-term follow-up. The mean pain score was 4.79 ± 3.2, and the lower extremity functional scale score was 43.5 ± 5.8. The QoL scores reflected overall improvement. However, 25.8% reported kinesiophobia, 17.3% reported pain catastrophizing, 17.6% reported elevated scores on the Central Sensitization Inventory, 5.6% reported depressive symptoms, 9.1% reported high stress, and 6.1% reported low self-efficacy. Significant correlations were observed between pain, function, and QoL scores and psychological variables after TKA. Despite overall favorable outcomes, some patients experienced persistent pain, functional limitations, and psychological distress. Comprehensive, biopsychosocial-informed follow-up is essential to optimize long-term recovery after TKA. The study protocol was registered with the Clinical Trial Registry-India (CTRI/2022/12/048118) on 14 December 2022.