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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2023

Open Access 05-05-2023 | KNEE

Optimism and pessimism are antithetically associated with post-operative knee function in patients’ undergoing total knee arthroplasty

Authors: Felix Wunderlich, Jasmin Ghaemi Kerahrodi, Robert Kuchen, Thomas Klonschinski, Yama Afghanyar, Erik Wegner, Philipp Drees, Lukas Eckhard

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2023

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Abstract

Purpose

Personality traits, such as dispositional optimism and pessimism, have impact on a variety of health-related problems. Influence on outcome in total knee arthroplasty (TKA) could only be shown for other personality trait concepts, but not for dispositional optimism/pessimism. This study aims to examine the association of dispositional optimism/pessimism with pre-operative joint function and post-operative outcome in TKA.

Methods

Data were acquired in a multicentre, cross-sectoral, prospective study (the PROMISE Trial). Patients were followed for 12 months post-operatively. Dispositional optimism/pessimism was measured pre-operatively via the revised Life Orientation Test (LOT-R), pre- and post-operative function was measured via the 12 Item Knee-osteoarthritis outcome Scores (KOOS-12). Log-linear regression models considering known confounders and t-test were carried out to show the association of LOT-R scores with pre- and post-operative KOOS-12 scores.

Results

740 patients were analyzed. Optimistic LOT-R was significantly positively associated to the mean scores of KOOS-12 pre- and post-operative, while pessimistic LOT-R was significantly associated negatively (pre-operative: optimistic p = 0.001, pessimistic p = 0.001; post-operative optimistic: 3M p = 0.001, 6M p = 0.001, 12M p = 0.001; post-operative pessimistic: 3M p = 0.01, 6M p = 0.004, 12M p = 0.001).

Conclusion

Optimism was positively associated with pre-operative joint function and, more importantly, post-operative functional outcome in TKA, while pessimism was associated with the opposite. Assessing patients’ general personality traits prior to surgery to identify pessimistic patients, hence being at risk for poor outcome in TKA, should be considered to react to the patients’ special needs and possible pessimistic expectations, i.e., through a cognitive–behavioral intervention, to potentially increase optimism and hereby post-operative outcome in TKA.

Level of evidence

Prognostic Level III.
Literature
1.
Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468:57–63CrossRefPubMed
2.
Conner-Spady BL, Bohm E, Loucks L, Dunbar MJ, Marshall DA, Noseworthy TW (2020) Patient expectations and satisfaction 6 and 12 months following total hip and knee replacement. Qual Life Res 29:705–719CrossRefPubMed
3.
Lützner C, Postler A, Beyer F, Kirschner S, Lützner J (2019) Fulfillment of expectations influence patient satisfaction 5 years after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27:2061–2070CrossRefPubMed
4.
Tolk JJ, Janssen RPA, Haanstra TM, Van Der Steen MMC, Bierma Zeinstra SMA, Reijman M (2020) Outcome expectations of total knee arthroplasty patients: the influence of demographic factors, pain, personality traits, physical and psychological status. J Knee Surg 33:1034–1040CrossRefPubMed
5.
Scott CEH, Howie CR, MacDonald D, Biant LC (2010) Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Jt Surg Br 92:1253–1258CrossRef
6.
Belford K, Gallagher N, Dempster M, Wolfenden M, Hill J, Blaney J et al (2020) Psychosocial predictors of outcomes up to one year following total knee arthroplasty. Knee 27:1028–1034CrossRefPubMed
7.
Bletterman AN, de Geest-Vrolijk ME, Vriezekolk JE, Nijhuis-van der Sanden MW, van Meeteren NLU, Hoogeboom TJ (2018) Preoperative psychosocial factors predicting patient’s functional recovery after total knee or total hip arthroplasty: a systematic review. Clin Rehabil 32:512–525CrossRefPubMed
8.
Vissers MM, Bussmann JB, Verhaar JAN, Busschbach JJV, Bierma-Zeinstra SMA, Reijman M (2012) Psychological factors affecting the outcome of total hip and knee arthroplasty: a systematic review. Semin Arthritis Rheum 41:576–588CrossRefPubMed
9.
Maruta T, Colligan RC, Malinchoc M, Offord KP (2000) Optimists vs pessimists: survival rate among medical patients over a 30-year period. Mayo Clin Proc 75:140–143CrossRefPubMed
10.
Novotny P, Colligan RC, Szydlo DW, Clark MM, Rausch S, Wampfler J et al (2010) A pessimistic explanatory style is prognostic for poor lung cancer survival. J Thorac Oncol 5:326332CrossRef
11.
Petersen LR, Clark MM, Novotny P, Kung S, Sloan JA, Patten CA et al (2008) Relationship of optimism–pessimism and health-related quality of life in breast cancer survivors. J Psychosoc Oncol 26:15–32CrossRefPubMed
12.
Scheier MF, Carver CS (1985) Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol 4:219–247CrossRefPubMed
13.
Balck F, Lippmann M, Jeszenszky C, Günther KP, Kirschner S (2016) The influence of optimism on functionality after total hip replacement surgery. J Health Psychol 21:1758–1767CrossRefPubMed
14.
Haanstra TM, Tilbury C, Kamper SJ, Tordoir RL, Vlieland TPMV, Nelissen RGHH et al (2015) Can optimism, pessimism, hope, treatment credibility and treatment expectancy be distinguished in patients undergoing total hip and total knee arthroplasty? PLoS One 10:1–15
15.
Singh JA, O’Byrne MM, Colligan RC, Lewallen DG (2010) Pessimistic explanatory style: a psychological risk factor for poor pain and functional outcomes two years after knee replacement. J Bone Jt Surg Br 92:799–806CrossRef
16.
Betz U, Langanki L, Heid F, Spielberger J, Schollenberger L, Kronfeld K et al (2021) The PROMISE study protocol: a multicenter prospective study of process optimization with interdisciplinary and cross-sectoral care for German patients receiving hip and knee endoprostheses. Acta Orthop 92:156–162CrossRefPubMed
17.
Schmitt J, Lange T, Günther K-P, Kopkow C, Rataj E, Apfelbacher C et al (2017) Indication criteria for total knee arthroplasty in patients with osteoarthritis—a multi-perspective consensus study. Z Orthop Unfall 155:539–548CrossRefPubMed
18.
Scheier MF, Carver CS, Bridges MW (1994) Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol 67:1063–1078CrossRefPubMed
19.
Glaesmer H, Rief W, Martin A, Mewes R, Brähler E, Zenger M et al (2012) Psychometric properties and population-based norms of the Life Orientation Test Revised (LOT-R). Br J Health Psychol 17:432–445CrossRefPubMed
20.
Herzberg PY, Glaesmer H, Hoyer J (2006) Separating optimism and pessimism: a robust psychometric analysis of the revised Life Orientation Test (LOT-R). Psychol Assess 18:433–438CrossRefPubMed
21.
Glaesmer H, Hoyer J, Klotsche J, Herzberg PY (2008) The German version of the Life-Orientation-Test (LOT-R) for dispositional optimism and pessimism. Eur J Health Psychol 16:26–31
22.
23.
Eckhard L, Munir S, Wood D, Talbot S, Brighton R, Walter B et al (2021) The KOOS-12 shortform shows no ceiling effect, good responsiveness and construct validity compared to standard outcome measures after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 29:608–615CrossRefPubMed
24.
Eckhard L, Munir S, Wood D, Talbot S, Brighton R, Walter WL et al (2021) Minimal important change and minimum clinically important difference values of the KOOS-12 after total knee arthroplasty. Knee 29:541–546CrossRefPubMed
25.
Gandek B, Roos EM, Franklin PD, Ware JE (2019) Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12). Osteoarthr Cartil 27:746–753CrossRef
26.
27.
Scheier MF, Matthews KA, Owens JF, Magovern GJ, Lefebvre RC, Abbott RA et al (1989) Dispositional optimism and recovery from coronary artery bypass surgery: the beneficial effects on physical and psychological well-being. J Pers Soc Psychol 57:1024–1040CrossRefPubMed
28.
Hanssen MM, Peters ML, Vlaeyen JWS, Meevissen YMC, Vancleef LMG (2013) Optimism lowers pain: evidence of the causal status and underlying mechanisms. Pain 154:53–58CrossRefPubMed
29.
Singh JA, Colligan RC, O’Byrne MM, Lewallen DG (2016) Do pessimists report worse outcomes after total hip arthroplasty? BMC Musculoskelet Disord 17:1–10CrossRef
30.
Alattas SA, Smith T, Bhatti M, Wilson-Nunn D, Donell S (2017) Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25:3403–3410CrossRefPubMed
31.
Tilbury C, Haanstra TM, Verdegaal SHM, Nelissen RGHH, De Vet HCW, Vliet Vlieland TPM et al (2018) Patients’ pre-operative general and specific outcome expectations predict postoperative pain and function after total knee and total hip arthroplasties. Scand J Pain 18:457–466CrossRefPubMed
32.
Bozo Ö, Gündoǧdu E, Büyükaşik-Çolak C (2009) The moderating role of different sources of perceived social support on the dispositional optimism-posttraumatic growth relationship in postoperative breast cancer patients. J Health Psychol 14:1009–1020CrossRefPubMed
33.
Scherer KR, Wranik T, Sangsue J, Tran V, Scherer U (2004) Emotions in everyday life: probability of occurrence, risk factors, appraisal and reaction patterns. Soc Sci Inf 43:499–570CrossRef
34.
Trinh JQ, Carender CN, An Q, Noiseux NO, Otero JE, Brown TS (2021) Resilience and depression influence clinical outcomes following primary total joint arthroplasty. J Arthroplast 36(5):1520–1526CrossRef
35.
Metadata
Title
Optimism and pessimism are antithetically associated with post-operative knee function in patients’ undergoing total knee arthroplasty
Authors
Felix Wunderlich
Jasmin Ghaemi Kerahrodi
Robert Kuchen
Thomas Klonschinski
Yama Afghanyar
Erik Wegner
Philipp Drees
Lukas Eckhard
Publication date
05-05-2023
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-023-07434-8

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