Association of postoperative pain and function with a preoperative pain catastrophizing score in temporomandibular joint prosthetic reconstruction.

Abstract

The Pain Catastrophizing Scale (PCS) assesses cognitive responses to pain through rumination, magnification, and helplessness. Though widely used, its role in evaluating patients undergoing temporomandibular joint (TMJ) replacement surgery has not been studied. This retrospective cohort study analyzed 98 patients who underwent total TMJ prosthetic reconstruction (TMJR) for treatment of severe osteoarthritis between 2018 and 2023. Preoperative PCS, Graded Chronic Pain Scale (GCPS), and Jaw Functional Limitation Scale-8 (JFLS-8) were recorded and compared with postoperative GCPS and JFLS-8 scores at 3-6 months (short-term) and 12-18 months (medium-term). The median preoperative PCS score was 17.5. Higher PCS scores were significantly associated with higher postoperative GCPS scores at short- and long-term follow-up (P = 0.031 and 0.048) and with higher (worse) short-term JFLS-8 scores (P = 0.039), though not at medium-term follow-up. GCPS correlated significantly with all PCS subscores in the short term, but only helplessness remained significant in medium term. JFLS-8 showed significant correlation with rumination and helplessness short term only. These findings suggest that PCS, particularly the helplessness component, is associated with pain and function outcomes after TMJ surgery and may help predict recovery. Incorporating PCS into preoperative assessment may aid surgical planning and patient counseling. Further research is warranted to validate its predictive utility and guide tailored interventions.