To assess the preliminary outcomes of the NOPAIN treatment, an acceptance and commitment therapy-based intervention, in preventing chronic postsurgical pain after total knee arthroplasty (TKA) and to evaluate predictors of moderate-to-severe pain at 3 months, including demographic and psychological factors.
Key Findings:
Pain intensity, knee pain, stiffness, and function improved significantly over time (P < .01), indicating a clinically relevant change.
Female sex and age were associated with lower odds of moderate-to-severe pain at 3 months.
Central sensitization, baseline pain intensity, rumination, and helplessness were associated with higher odds of moderate-to-severe pain.
Interpretation:
The NOPAIN treatment is feasible and can be integrated into standard rehabilitation care, potentially contributing to the prevention of chronic postsurgical pain.
Limitations:
Non-controlled trial limits generalizability and introduces potential biases.
Small sample size may affect the robustness of findings and statistical power.
Further studies needed to confirm results and refine the intervention, particularly focusing on diverse populations.
Conclusion:
The preliminary results suggest that ACT-based interventions like NOPAIN may help mitigate chronic pain following TKA, warranting further research to explore specific mechanisms and long-term effects.
by Emanuele Maria Giusti, Gianluca Castelnuovo, Chiara Manna, Giorgia Varallo, Roberto Cattivelli, Benito Vanni Petrachi, Marco Stramba-Badiale, Chiara A M Spatola
In a small open-label randomized trial, 2 platelet-rich plasma injections were associated with greater 6-month improvements in pain and function than corticosteroid injection or oral aceclofenac among patients awaiting knee arthroplasty.
Operative-time–adjusted findings favored the ipsilateral technique, while absolute fluoroscopy time and radiation exposure remained similar between approaches.
