Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Psychosocial Aspects of Musculoskeletal Illness 13 articles


One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress

Michael Q. Potter MD, James D. Wylie MD, Erin K. Granger MPH, Patrick E. Greis MD, Robert T. Burks MD, Robert Z. Tashjian MD

Patients with shoulder and rotator cuff pathology who exhibit greater levels of psychological distress report inferior preoperative self-assessments of pain and function. In several other areas of orthopaedics, higher levels of distress correlate with a higher likelihood of persistent pain and disability after recovery from surgery. To our knowledge, the relationship between psychological distress and outcomes after arthroscopic rotator cuff repair has not been similarly investigated.

What Is the Impact of Comorbidities on Self-rated Hand Function in Patients With Symptomatic Trapeziometacarpal Arthritis?

Ryan Calfee MD, MSc, Jennifer Chu MD, Amelia Sorensen MD, Erin Martens MD, John Elfar MD

The thumb trapeziometacarpal joint is one of the most common sites of arthritic degeneration prompting specialty care. Surgical treatment algorithms are based on radiographic arthritic progression. However, the pain and disability attributable to trapeziometacarpal arthritis do not correlate with arthritic stage, and depression has independently predicted poorer self-rated hand function both at baseline and after treatment in patients’ atraumatic hand conditions.

Do Patient- and Parent-reported Outcomes Measures for Children With Congenital Hand Differences Capture WHO-ICF Domains?

Joshua M. Adkinson MD, Rebecca S. Bickham BS, Kevin C. Chung MD, MS, Jennifer F. Waljee MD, MS

Patient- and parent-reported outcome measures (PROMs) are increasingly used to evaluate the effectiveness of surgery for congenital hand differences (CHDs). Knowledge of an existing outcome measure’s ability to assess self-reported health, including psychosocial aspects, can inform the future development and application of PROMs for CHD. However, the extent to which measures used among children with CHD align with common, accepted metrics of self-reported disability remains unexplored.

Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Kristin R. Archer PhD, DPT, Christine M. Abraham MA, MEd, William T. Obremskey MD, MPH

There has been increasing evidence to support the importance of psychosocial factors to poor outcomes after trauma. However, little is known about the contribution of pain catastrophizing and fear of movement to persistent pain and disability.

Does Race Affect Outcomes in Total Joint Arthroplasty?

Carlos J. Lavernia MD, Jesus M. Villa MD

Several studies suggest worse surgical outcomes among racial/ethnic minorities. There is a paucity of research on preoperative and postoperative pain, general health, and disease-specific measures in which race is the main subject of investigation; furthermore, the results are not conclusive.

What Is the Most Useful Questionnaire for Measurement of Coping Strategies in Response to Nociception?

Joost T. P. Kortlever BSc, Stein J. Janssen MD, Marijn M. G. Berckel BSc, David Ring MD, PhD, Ana Maria Vranceanu PhD

There are several measures of coping strategies in response to nociception. These measures all correlate highly both with each other and with symptom intensity and magnitude of disability in patients with upper limb illness. This study aims to determine if distinct measures of coping strategies in response to nociception address the same underlying aspect of human illness behavior.

Do Upper Extremity Trauma Patients Have Different Preferences for Shared Decision-making Than Patients With Nontraumatic Conditions?

Michiel G. J. S. Hageman MD, Rajesh Reddy BA, Dennis J. S. Makarawung BSc, Jan Paul Briet MD, C. Niek Dijk MD, PhD, David Ring MD, PhD

Shared decision-making is a combination of expertise, available scientific evidence, and the preferences of the patient and surgeon. Some surgeons contend that patients are less capable of participating in decisions about traumatic conditions than nontraumatic conditions.

Do Surgeons Treat Their Patients Like They Would Treat Themselves?

Stein J. Janssen MD, Teun Teunis MD, Thierry G. Guitton MD, PhD, David Ring MD, PhD

There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences.

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Young Hak Roh MD, Jung Ho Noh MD, Joo Han Oh MD, Hyun Sik Gong MD, Goo Hyun Baek MD

Patients with hand fractures often have pain, swelling, and stiffness in the joints of the hand, which may lead them to protect their hands, resulting in more stiffness and in delayed recovery. However, the effects of pain-coping strategies and catastrophization (the tendency to expect the worst to occur when pain is present, an approach that can be thought of as the opposite of “coping”) on functional recovery after hand fractures have not been investigated in depth.

Does Rotator Cuff Repair Improve Psychologic Status and Quality of Life in Patients With Rotator Cuff Tear?

Chul-Hyun Cho MD, PhD, Kwang-Soon Song MD, Ilseon Hwang MD, Jon J. P. Warner MD

Recently, psychological status, patient-centered outcomes, and health-related quality of life (HRQoL) in patients with scheduled or who underwent orthopaedic surgeries have been emphasized. The relationship between preoperative psychological status and postoperative clinical outcome in patients with rotator cuff repair has not yet been investigated.

Does Disability Correlate With Impairment After Hand Injury?

Maryam Farzad PhD, Ali Asgari PhD, Fatemeh Dashab MSc, Fereydoun Layeghi MD, Masoud Karimlou PhD, Seyed Ali Hosseini PhD, Mehdi Rassafiani PhD

Any loss or deviation in body function and structure is considered impairment, whereas limitations on activities are fundamental to the definition of disability. Although it seems intuitive that the two should be closely related, this might not be the case; there is some evidence that psychosocial factors are more important determinants of disability than are objective impairments. However, the degree to which this is the case has been incompletely explored.

What Is the Relationship Between Depressive Symptoms and Pain During Functional Tasks in Persons Undergoing TKA? A 6-year Perioperative Cohort Study

Daniel L. Riddle PT, PhD, Robert A. Perera PhD, William T. Nay PhD, Levent Dumenci PhD

Preoperative depressive symptoms have been shown in some but not all studies to be associated with poor self-reported pain and function outcomes. In addition, depressive symptoms after surgery have been shown to improve relative to preoperative levels.