Recent research suggests that psychological distress generally and pain catastrophizing, more specifically, plays a key role in determining which patients with knee arthroplasty have a poor outcome. A substantial literature suggests that cognitive behavioral therapy is effective for patients with chronic pain but the intervention has not been studied for patients with knee arthroplasty. We designed the Knee Arthroplasty cognitive Behavioral Intervention for pain Catastrophizing (KABIC) trial to address this research need. We hypothesize that a cognitive behavioral intervention applied to patients with high levels of pain catastrophizing will lead to clinically important pain and functional improvements at one year as compared to patients who receive an arthritis educational control intervention. A steering committee of experienced trialists, psychologists and knee arthroplasty researchers has been formed to develop the design for the KABIC trial. The clinical trial planning grant is necessary to meet the following specific aims: 1) Utilize a Steering Committee consisting of interdisciplinary experts to;(a) lead a well-organized clinical trial planning process, (b) finalize the study design, (c) assess feasibility, and (d) develop a preliminary study budget. 2) Write a detailed Manual of Procedures for the KABIC trial 3) Obtain strong commitments from multiple clinical sites that will participate in the trial, and a) gather data from each site that will lead to optimal patient recruitment and retention strategies, and b) accurately determine the size and diversity of the patient population likely to be recruited into the trial. This project seeks to combine a strong and diverse group of researchers to examine an understudied area in the joint arthroplasty literature. Approximately 25% of patients following knee arthroplasty have disabling pain following apparently successful surgery. The KABIC trial will be among the first to examine an intervention for this substantial population of patients.
Approximately 25% of patients have persistent and disabling pain and poor function following primary knee arthroplasty. Psychological distress likely contributes to a large number of these poor outcomes. The proposed study will test an intervention designed to reduce pain and enhance the functional status of patients at high risk for poor outcome following knee arthroplasty.
