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, n = 35) received enhanced recovery protocols with standard pain management, while the control group (May-June, n = 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 ( P < 0 . 001 ), temporal effects (P ¡ 0.001), and group-time interaction effects ( P < 0 . 001 ) 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 = 16,T2 = 9,T3 = 5 versus T1 = 29,T2 = 23,T3 = 19.5), pain intensity (Pain: T1 = 4,T2 = 2.5,T3 = 1 versus T1 = 4,T2 = 3,T3 = 2) and pain management outcomes (APS-POQ-C: T1 = 12.125,T2 = 3.875,T3 = 1.25 versus T1 = 15.75,T2 = 9.5,T3 = 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.