The Effect of Preoperative Pain Science Education on Postoperative Outcomes and Perceptions of Self-Efficacy Following Total-Joint Replacement

Bradley M. Kruse, University of St. Augustine for Health Sciences


The number of people experiencing arthritis related pain and subsequent limitations in function are growing. One outcome related to this trend is the increase in the number of osteoarthritis related total knee arthroplasty (TKA) and total hip arthroplasty (THA) surgeries. Following surgery, pain is typically addressed pharmacologically. Despite the use of medication, persistent levels of postoperative pain often continue (Mahoney, Noble, Davidson &Tullos 1990). A complex interaction between neurobiological and psychological components determines an individual’s pain experience and subsequent degree of physical limitation following surgery (Bandura et al 1987; Orbell et al 1998; Faller, Kirschner & Konig 2003, Caracciolo & Giaquinto 2005). Preoperative patient education has been utilized as a means to reduce postoperative complications related to pain and functional limitation for a variety of conditions (Louw et al 2012; Moon & Backer 2000; Faller, Kirschner & Konig 2003). The traditional model of preoperative patient education has been successful to a degree (Moon & Backer 2000, McDonald et al 2014). However, many patients continue to report pain and functional limitations as significant postoperative complications, indicating that there may be deficiencies in the current model of preoperative patient education (Louw 2012). Preoperative education that includes pain neuroscience education may provide a means to address the biopsychosocial component of the individual pain experience and subsequently improve postoperative outcomes.