Thompson Kamali, Kramarchuk Mark, Yagnatovsky Michelle, Kunichoff Dennis, Zacchilli Michael, Campbell Kirk A, Alaia Michael, Jazrawi Laith, Strauss Eric
NYU Langone Health, Department of Orthopedic Surgery, Division of Sports Medicine, New York, NY 10016, USA.
Hofstra Northwell School of Medicine, Hempstead, NY 11549, USA.
J Orthop. 2020 May 5;21:283-286. doi: 10.1016/j.jor.2020.04.021. eCollection 2020 Sep-Oct.
The traditional nociceptive approach to pain identifies the mind and body as functionally separate. However, the biopsychosocial model accounts for the impact of social, psychological and physical factors on the patient experience. The purpose of this study was to determine the relationship between diagnosis, physical disability, and psychological distress among patients with anterior knee pain-one of the most common complaints in an orthopedic clinic.
This was a single-center, cross-sectional study. Patients presenting for initial evaluation of knee pain completed the Pain Catastrophizing Scale, Kujala Anterior Knee Pain Scale, and SF-12 questionnaires. Statistical analysis was performed using SPSS Version 24.
207 patients, 108 (52.2%) females and 99 (47.8%) males, with a mean age 44.5 ± 15.4 years were enrolled. The osteoarthritis cohort had the highest pain catastrophizing score (17 ± 14.5), lowest Kujala score (48.3 ± 18.1), lowest SF-12 PCS (37.5 ± 8.3), and lowest SF-12 MCS (50.8 ± 11.0). Across all diagnoses, there was a statistically significant negative correlation between the total Pain Catastrophizing Score (PCS) and the Kujala, SF-12 Physical, and SF-12 Mental Component Scores. Bivariate and multivariate analysis demonstrated a correlation between PCS and duration of symptoms and African-Americans. The Kujala and SF-12 PCS demonstrated a statistically significant correlation with age, smoking, and the Asian Indian ethnicity. The SF-12 MCS showed a significant relationship with the Asian Indian ethnicity. Bivariate analysis also showed a statistically significant relationship between the SF-12 PCS and the SF-12 MCS.
Knee pain patients presenting to an orthopedic sports medicine clinic demonstrate diminished physical quality of life and psychological reserves. This study determined an association between catastrophizing behavior and other patient reported outcomes measuring pain, physical distress, quality of life and mental/emotional well-being. To optimize patient outcomes, psychological domain should be managed contemporaneously to orthopedic pathology.
传统的疼痛伤害感受方法认为身心在功能上是分开的。然而，生物心理社会模型考虑了社会、心理和生理因素对患者体验的影响。本研究的目的是确定前膝痛患者（骨科门诊最常见的主诉之一）的诊断、身体残疾和心理困扰之间的关系。
这是一项单中心横断面研究。因膝痛前来进行初次评估的患者完成了疼痛灾难化量表、库亚拉前膝痛量表和SF-12问卷。使用SPSS 24版进行统计分析。
共纳入207例患者，其中女性108例（52.2%），男性99例（47.8%），平均年龄44.5±15.4岁。骨关节炎队列的疼痛灾难化评分最高（17±14.5），库亚拉评分最低（48.3±18.1），SF-12生理综合评分最低（37.5±8.3），SF-12心理综合评分最低（50.8±11.0）。在所有诊断中，疼痛灾难化总分（PCS）与库亚拉评分、SF-12生理评分和SF-12心理评分之间存在统计学显著的负相关。双变量和多变量分析表明PCS与症状持续时间和非裔美国人之间存在相关性。库亚拉评分和SF-12生理评分与年龄、吸烟和亚洲印度族裔存在统计学显著相关性。SF-12心理评分与亚洲印度族裔存在显著关系。双变量分析还显示SF-12生理评分和SF-12心理评分之间存在统计学显著关系。
到骨科运动医学门诊就诊的膝痛患者表现出身体生活质量和心理储备下降。本研究确定了灾难化行为与其他患者报告的测量疼痛、身体困扰、生活质量和心理/情绪健康的结果之间的关联。为了优化患者的治疗效果，心理领域应与骨科病理同时进行管理。
