Approximately 25% of patients following knee arthroplasty have disabling pain following apparently successful surgery. Recent research suggests that pain catastrophizing plays a key role in determining which patients with knee arthroplasty have a poor outcome. In addition to this evidence, a substantial literature suggests that pain coping skills training is effective for patients with chronic pain but the intervention hs not been studied for surgical patients with severe arthritic knee pain. We designed the Knee Arthroplasty pain coping Skills Training (KASTpain) trial to address this research need. This Phase III three-arm randomized clinical trial seeks to combine a strong and diverse group of researchers to examine an important and understudied area in the joint arthroplasty literature. The KASTpain trial will be the first to examine the utility of a perioperative pain coping intervention for this substantial population of patients. The clinical trial grant is designed to met the following specific aims: 1) to determine if a pain coping skills training intervention provided by psychologists is more effective at reducing pain and improving function and is more cost effective than arthritis education or usual care and 2) to determine if changes in pain and function following pain coping skills training are mediated by changes in pain catastrophizing. A tertiary aim will be to determine if pain coping skills training is more cost effective than either arthritis education or usual care. We expect that the study will have a substantial impact on clinical practice by providing evidence in support of a new treatment paradigm; a perioperative pain coping skills training approach for knee arthroplasty patients at-risk for poor outcome.
We expect that the study will have a substantial impact on public health by providing evidence in support of a new treatment paradigm; a perioperative pain coping skills training approach for thousands of knee arthroplasty patients at-risk for poor outcome.
