Effect of a Patient Education in Pain Coping for Patients Scheduled for Total Knee Arthroplasty

January 27, 2020 updated by: Sara Birch, Regional Hospital West Jutland

Effect of a Patient Education in Pain Coping for Patients With High Levels of Pain Catastrophizing Before Total Knee Arthroplasty

The aim of this study is to investigate, whether a patient education with focus on pain coping is able to improve physical function and experienced pain level in patients with high levels of pain catastrophizing before Total Knee Arthroplasty. Resent studies indicates that these patients do not achieve a satisfactory pain relief and physical function after TKA. Furthermore, the aim is to determine if there is a difference in physical activity and muscle mass among patients with high levels of pain catastrophizing compared to patients with low levels of pain catastrophizing.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

In Denmark, are approximately 8000 patients operated annually with Knee Arthroplasty. Most of these patients will have less pain and higher functional ability after the surgery. However, some patients respond poorly to the surgery and approximately 20% of the patients report persistent function-limiting pain six months or more following a total knee arthroplasty (TKA).

Research has shown that patients with high pain catastrophizing scores are at higher risk of having persistent pain and lower physical function after the operation.

This study consists of two parts. The first part is a randomised controlled trial where 56 patients with high levels of pain catastrophizing before TKA are randomised to either treatment as usual (control group 1), which implies surgery and the standard postoperative rehabilitation, or in addition to this, a patient education focusing on pain behaviour and pain coping (patient education). In the second part the patients in control group 1 will be matched on age, BMI and gender with additionally 28 patients with a low levels of pain catastrophizing (control group 2).

Study Type

Interventional

Enrollment (Anticipated)

84

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Holstebro, Denmark, 7500
        • Regional Hospital Holstebro

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age above 18 years
  • Inability to understand and communicate with the investigators
  • Scheduled for an elective unilateral total knee arthroplasty
  • Primary diagnosis of osteoarthritis
  • Score greater than 22 or lower than 12 on the Pain Catastrophizing Scale (PCS)

Exclusion Criteria:

  • Planned to undergo another elective joint replacement procedure during the 12 months period of participation
  • Scheduled for revision arthroplasty surgery
  • TKA surgery scheduled because of fracture, malignancy or infection
  • Scheduled for Unicompartmental knee arthroplasty
  • Major depression diagnosed with the Major Depression Index (MDI)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patienteducation
(Patients with PCS>22). An education in pain coping delivered by physiotherapists. The education consist of seven sessions over a four months period. Each session is individual and will last 30 minutes. Focus will be on pain behaviour and pain coping based on Cognitive Behavioral Therapy.
No Intervention: Control group 1
(Patients with PCS>22). Patients randomly assigned to this arm will undergo usual treatment for total knee arthroplasty.
No Intervention: Control group 2
(Patients with PCS<12). Patients in this arm will undergo usual treatment for total knee arthroplasty. Patients in this arm are not randomized but matched by age, gender and BMI with patients in control group 1.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Pain measured on a Visual Analog Scale (0-100)
Time Frame: 12 months
12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Six-minute Walk Test
Time Frame: 12 months
12 months
Sit-to-stand in 30 seconds
Time Frame: 12 months
12 months
EuroQol (EQ-5D)
Time Frame: 12 months
12 months
Pain Catastrophizing Scale
Time Frame: 12 months
12 months
Knee injury and Osteoarthritis Outcome Score (KOOS)
Time Frame: 12 months
12 months
Short Form 36 (Physical Function)
Time Frame: 12 months
12 months
Dual Energy X-ray Absorptiometry (DXA) scan
Time Frame: 12 months
To detect muscle mass
12 months
Tri-axial-accelerometer
Time Frame: 12 months
To measure physical activity for seven days
12 months
Oxford Knee Score
Time Frame: 12 months
12 months
Pain Self-Efficacy Questionnaire (PSEQ)
Time Frame: 12 months
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: Torben B Hansen, professor,MD, University Clinic for Hand, Hip and Knee Surgery, HolstebroRegional Hospital, Aarhus University, Denmark

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2015

Primary Completion (Anticipated)

May 1, 2020

Study Completion (Anticipated)

January 1, 2021

Study Registration Dates

First Submitted

October 23, 2015

First Submitted That Met QC Criteria

October 23, 2015

First Posted (Estimate)

October 27, 2015

Study Record Updates

Last Update Posted (Actual)

January 28, 2020

Last Update Submitted That Met QC Criteria

January 27, 2020

Last Verified

January 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • VEK 1-10-72-64-15

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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