Effects of empowered relief on pain catastrophizing and outcomes post-total knee arthroplasty: a quasi-experimental study

Background: Total knee arthroplasty (TKA) is the most effective surgical method for end-stage knee joint diseases, yet chronic postoperative pain related to pain catastrophisation remains a major cause of patient dissatisfaction, warranting evaluation of Empowered Relief (ER) in TKA patients. Objective: This quasi-experimental study evaluated digital ER’s effectiveness in reducing pain catastrophizing post-TKA. Methods: This quasi-experimental study enrolled 70 primary unilateral TKA patients at a tertiary hospital in Lanzhou, China (March–June 2023). Participants were allocated by admission date: the intervention group (March–April, [Formula: see text] 35) received enhanced recovery protocols with standard pain management, while the control group (May–June, [Formula: see text] 35) received standard management alone. Pain outcomes were assessed at postoperative weeks 2 (T1), 1 month (T2), and 3 months (T3) using validated tools: Pain Catastrophizing Scale (PCS), Numerical Rating Scale (NRS), and APS-POQ-C (Chinese version) to evaluate catastrophisation, intensity, and management efficacy. Generalized Estimating Equations (GEEs) were employed for longitudinal statistical analysis. Results: The ER program showed statistically significant main effects across groups ([Formula: see text]), temporal effects (P Γ 0.001), and group-time interaction effects ([Formula: see text]) on pain catastrophisation scores, pain intensity scores, and pain management outcomes, respectively. And as time went on, the intervention group showed greater improvement than the control group in pain catastrophizing (PCS:T1[Formula: see text]16,T2[Formula: see text]9,T3[Formula: see text]5 versus T1[Formula: see text]29,T2[Formula: see text]23,T3[Formula: see text]19.5), pain intensity (Pain: T1[Formula: see text]4,T2[Formula: see text]2.5,T3[Formula: see text]1 versus T1[Formula: see text]4,T2[Formula: see text]3,T3[Formula: see text]2) and pain management outcomes (APS-POQ-C: T1[Formula: see text]12.125,T2[Formula: see text]3.875,T3[Formula: see text]1.25 versus T1[Formula: see text]15.75,T2[Formula: see text]9.5,T3[Formula: see text]5). Conclusions: The ER program significantly reduced postoperative pain intensity and catastrophisation in TKA patients, enhancing pain management outcomes compared to conventional therapies. Its concentrated 2 h format demonstrates promising efficacy over standard care, offering a streamlined alternative to traditional postoperative regimens.