High Pain Self-Efficacy Reduces the Use of Analgesics in the Early Postoperative Period After Total Knee Arthroplasty: A Retrospective Cohort Study.

Background: Total knee arthroplasty (TKA) is an effective treatment for relieving pain and restoring physical function in individuals with severe knee osteoarthritis (KOA). However, the persistence of postoperative pain is an unresolved problem, and the use of postoperative analgesics to deal with this pain is increasing. The positive cognitive factor known as pain self-efficacy (PSE) has been shown to moderate the intensity of pain, but there are few reports of PSE concerning analgesic use after TKA. We sought to clarify the effect of PSE on postoperative analgesic use in TKA cases.

Patients and methods: We conducted a retrospective cohort study of 60 patients who underwent bilateral TKA surgery for bilateral severe KOA. A multiple linear regression model including covariates and scaling estimation coefficients was used to investigate the effect of PSE on the patients' postoperative analgesic use. We identified the presence/absence of postoperative analgesic use at 3 and 6 months postoperatively, and other evaluation items such as the Pain Self-Efficacy Questionnaire (PSEQ) were evaluated at the time of the patients' admission for surgery.

Results: In a multiple linear regression model, only high PSE had a significant impact on the postoperative 3-month use of nonsteroidal anti-inflammatory drugs (NSAIDs) (β: -0.27, 95% confidence interval [CI]: -0.51, -0.01). However, the significant difference had disappeared postoperative 6 months (β: -0.06, 95% CI: -0.19, 0.31).

Conclusion: These results demonstrated that high pain self-efficacy reduced the analgesic use at 3 months postoperatively by patients who have undergone bilateral TKA surgery, but it did not affect analgesic use at 6 months postoperatively. Pain self-efficacy can be an intervention target for reducing the use of analgesics after TKA surgery. Further research is needed to clarify the relationship between pain self-efficacy and the post-TKA use of analgesics.