{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T07:53:19Z","timestamp":1794210799528,"version":"4.8.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:00:00Z","timestamp":1722124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HSS Journal\u00ae: The Musculoskeletal Journal of Hospital for Special Surgery"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    Total knee arthroplasty (TKA) is a common surgical remedy for patients with end-stage osteoarthritis. Although TKA is generally effective, a significant number of patients experience chronic post-surgical pain. Psychosocial interventions have increasingly become an area of interest in pain management following surgical procedures.\n                    <jats:italic toggle=\"yes\">Purpose:<\/jats:italic>\n                    We aimed to evaluate the impact of pre-operative, peri-operative, and post-operative psychosocial interventions on reducing the likelihood of developing chronic pain after TKA.\n                    <jats:italic toggle=\"yes\">Methods:<\/jats:italic>\n                    We performed a systematic review following the Cochrane guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A comprehensive search strategy was employed using PubMed, Embase, and Cochrane Central Register of Controlled Trials. Inclusion criteria were (1) patients undergoing; (2) pain outcome assessed \u22651 month post-operatively; (3) prospective and longitudinal study design (eg, randomized controlled trial, experimental non-randomized trial, cohort, case-control studies with measurement of exposure prior to outcome); (4) English language; and (5) psychosocial intervention (cognitive-behavioral, biopsychosocial, dialectical behavioral, psychoeducation, mindfulness, meditation, psychotherapy, relaxation, mind-body therapies, hypnosis). Exclusion criteria were non-primary literature (eg, review articles), non\u2013peer-reviewed studies, and conference proceedings. The methodological quality of included studies was assessed using Cochrane\u2019s tool for Risk of Bias 2 (RoB 2), the methodological index for non-randomized studies (MINORS), and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I).\n                    <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    Of 4297 studies reviewed with title and abstract, 4160 were excluded. Of the remaining 137 studies that underwent full-text review, 122 were excluded using the same inclusion and exclusion criteria, and 15 studies were included. Our review indicates a variable but positive impact of psychosocial interventions, such as pre-operative education, relaxation techniques, and cognitive-behavioral therapy, on post-TKA pain. Of the 15 included studies, 9 studies found that psychosocial interventions reduced post-TKA pain. Our review also suggests that cognitive-behavioral therapy may aid in reducing kinesiophobia, pain catastrophizing, and knee pain intensity. For the 12 randomized studies, the risk of bias was deemed \u201chigh\u201d concerns for 3 studies, \u201csome\u201d concerns for 5 studies, and \u201clow\u201d concerns for 4 studies. For the 3 non-randomized studies, the risk of bias was deemed \u201cmoderate\u201d due to confounding bias.\n                    <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    This systematic review of level-I and level-II studies found that the integration of psychosocial interventions into care protocols for TKA offers benefits including improved patient satisfaction and quality of life and reduced health care costs. Limitations include heterogeneity in intervention types and outcomes measured and the varying levels of risk of bias across studies, which may affect the generalizability of the findings. The findings support a broader adoption of holistic, patient-centered approaches in pain management after TKA, emphasizing the importance of psychological well-being for optimal patient outcomes. However, the evidence is limited and constitutes a strong impetus for the further study of these interventions.\n                  <\/jats:p>","DOI":"10.1177\/15563316241260717","type":"journal-article","created":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T09:15:49Z","timestamp":1722158149000},"page":"71-79","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Psychosocial Interventions to Reduce Post operative Pain in Total Knee Arthroplasty: A Systematic Review"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7832-4679","authenticated-orcid":false,"given":"Carolena","family":"Rojas Marcos","sequence":"first","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"},{"name":"Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Schiller","sequence":"additional","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4175-8718","authenticated-orcid":false,"given":"Sebastian","family":"Braun","sequence":"additional","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9\u2014University Hospital Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Knauer","sequence":"additional","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Yadeau","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allina","family":"Nocon","sequence":"additional","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8707-4859","authenticated-orcid":false,"given":"Bridget","family":"Jivanelli","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-4846","authenticated-orcid":false,"given":"Dimitrios A.","family":"Flevas","sequence":"additional","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Sculco","sequence":"additional","affiliation":[{"name":"Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,7,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-17-00283"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-015-0276-x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/20494637231204549"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22744"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000435"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jajs.2020.09.005"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1694312"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1119-9"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-102258"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.10.035"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-021-01870-7"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033248"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2019.08.010"},{"key":"e_1_3_2_15_2","volume-title":"Psychosocial Interventions for Mental and Substance Use Disorders: A Framework for Establishing Evidence-Based Standards","author":"England MJ","year":"2015","unstructured":"England MJ, Butler AS, Gonzalez ML, Committee on Developing Evidence-Based Standards for Psychosocial Interventions for Mental Disorders; Board on Health Sciences Policy; Institute of Medicine, eds. 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