Abstract
Purpose
To determine whether preoperative psychological status before outpatient knee surgery
is influenced by athletic status, symptom chronicity, or prior surgical history.
Methods
International Knee Documentation Committee subjective scores (IKDC-S), Tegner Activity
Scale scores, and Marx Activity Rating Scale scores were collected. Psychological
and pain surveys included the McGill pain scale, Pain Catastrophizing Scale, Tampa
Scale for Kinesiophobia 11, Patient Health Questionnaire 9, Perceived Stress Scale,
New General Self-Efficacy Scale, and Life Orientation Test–Revised for optimism. Linear
regression was used to determine the effects of athlete status, symptom chronicity
(>6 months or ≤6 months), and history of prior surgery on preoperative knee function,
pain, and psychological status after matching for age, sex, and surgical procedure.
Results
In total, 497 knee surgery patients (247 athletes, 250 nonathletes) completed a preoperative
electronic survey. All patients were age 14 years and older and had knee pathology
requiring surgical treatment. Athletes were younger than nonathletes on average (mean
[SD], 27.7 [11.4] vs 41.6 [13.5] years; P < .001). The most frequently reported level of play among athletes was intramural
or recreational (n = 110, 44.5%). Athletes had higher preoperative IKDC-S scores (mean
[SE], 2.5 [1.0] points higher; P = .015) and lower McGill pain scores compared to nonathletes (mean [SE] 2.0 [0.85]
points lower; P = .017). After matching for age, sex, athlete status, prior surgery, and procedure
type, having chronic symptoms resulted in higher preoperative IKDC-S (P < .001), pain catastrophizing (P < .001), and kinesiophobia scores (P = .044).
Conclusions
Athletes demonstrate no difference in symptom/pain and function scores preoperatively
when compared to nonathletes of similar age, sex, and knee pathology, as well as no
difference in multiple psychological distress outcomes measures. Patients with chronic
symptoms have more pain catastrophizing and kinesiophobia, while those who have had
prior knee surgeries have slightly higher preoperative McGill pain score.
Level of Evidence
Level III, cross-sectional analysis of prospective cohort study data.
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Article info
Publication history
Published online: December 07, 2022
Accepted:
October 26,
2022
Received:
March 9,
2021
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
