Influence of fear of movement on total knee arthroplasty outcome
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Abstract
AIM: The aim of the study was to investigate the occurence of postoperative fear of movement in total knee arthroplasty (TKA) patients and to determine the association of fear of movement with established outcome measures.
METHODS: A prospective study included 78 patients with primary TKA for osteorthritis. The occurence of fear of movement was assessed by Tampa Scale of Kinesiophobia (TSK). The patients were assessed at three time points: 2 weeks, 4 weeks and 6 months after the surgery. Pain and flexion were measured at all the three time points while function according to the Oxford knee score 1 was evaluated only at 6 month after surgery.
RESULTS: Fear of movement occurred in 17 patients (21.8%). Patients with a high degree of fear of movement showed significantly poorer results compared to those with a low degree in terms of pain, flexion and function. Improvement in pain and flexion over time was achieved in both groups but it was significantly greater in the low degree fear of movement group.
DISCUSSION: Our study showed that postoperative fear of movement was significantly associated with pain, flexion and function. Other authors found that preoperative level of fear of movement was a predictor of postoperative functional limitations.
CONCLUSIONS: Fear of movement occurred in a substantial proportion of patients after TKA and it was associated with knee pain, flexion and function. According to our results fear of movement may represent a risk for poor TKA outcome.