Pain catastrophizing and related influencing factors in pro-operative total knee arthroplasty in Lanzhou, China : a cross-sectional study

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Background The pain catastrophizing of preoperative total knee arthroplasty (TKA) patients is influenced by many factors and have not been well characterized in the literature. Therefore, the present study aims to investigate the current state and risk factors of pro-operative pain catastrophizing in subjects undergoing TKA. Methods This descriptive cross-sectional study was conducted at the orthopaedics ward of two tertiary hospitals in Lanzhou, China. The Chinese version of the Pain Catastrophizing Scale (PCS), the SF-36 (the physical function domain), the Numerical Rating Scale (NRS), the Oxford Knee Score (OKS), the Hospital Anxiety and Depression Scale (HADS) and the Life Orientation Test-Revised (LOT-R) were used. Results The study included 360 participants. Among all participants, pro-operative TKA patients’ pain catastrophizing was at a high level, with a mean score of 24.92 (SD 12.38). The stepwise multiple linear regression analysis showed that anxiety ( β = 0.548, P < 0.01), education level ( β =-0.179, P < 0.01), physical function ( β =-0.156, P < 0.01), and pain intensity during activity ( β = 0.105, P = 0.015) are influencing factors for pain catastrophizing, which could explain 51.2% of the total variation in pain catastrophizing ( F =95.149, P < 0.01). Conclusion Anxiety is the most important variable influencing pain catastrophizing in pro-operative TKA patients, and lower education levels, poor physical function and stronger pain intensity during activity were also associated with higher pain catastrophizing.