Preoperative Cognitive Therapy for Improving Health Outcomes After TKA in High-risk Catastrophizing Subjects



Status:Recruiting
Healthy:No
Age Range:18 - 85
Updated:5/23/2018
Start Date:January 2013
End Date:December 2019
Contact:Mario Moric
Email:mario_moric@rush.edu
Phone:312-942-2806

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Preoperative Cognitive Therapy for Improving Health Outcomes After Total Knee Replacement in High-risk Catastrophizing Subjects

The investigators propose a randomized controlled trial to evaluate the effects of treatment
intended to reduce pain catastrophizing among patients reporting high pain catastrophizing
prior to total knee replacement(TKR), total hip replacement(THR), or shoulder surgery in an
effort to thereby reduce the incidence of persistent post-surgical pain (PPP) and enhance
physical function at 3-months post-surgery. Preemptive treatment aimed at a known predictor
of PPP following total knee replacement is highly innovative and have potentially high impact
for public health. Cognitive therapy is a well-tolerated modality among chronic pain patients
with few if any side effects. Cognitive therapy (CT) represents an inexpensive method that
could greatly reduce suffering and costly post-surgical pain management for high risk TKR
patients.

Aim 1 is to determine which CT protocol is most effective in reducing Pain Catastrophizing
Scale (PCS) and Coping Strategies Questionnaire Catastrophizing Subscale (CSQ-CAT) scores in
high-risk TKR candidates. CT will consist of four-to-eight weekly 1-hr individual cognitive
therapy sessions prior to surgery.

Inclusion Criteria:

1. undergoing standard primary TKR; THR or Shoulder Surgery

2. 18- 85 yrs of age;

3. Surgical joint is the primary source of patient's pain;

4. Patient agrees to preoperative visits and treatment, follow-up visits and treatment,
and to comply with the assessment tests;

5. Patient consents to standard anesthetic and analgesic protocol, with medical care as
deemed necessary by the anesthesiologist, and has no contraindications.

6. Patient has been diagnosed with osteoarthritis.

Exclusion Criteria:

1. Currently using antidepressant medication or undergoing cognitive therapy;

2. chronic opioid use ≥ 10 mg/day of morphine equivalents within one wk prior to the
surgery, and duration of use > 4 wks;

3. history of opioid abuse;

4. inability to understand and communicate with the investigators to complete the study
related questionnaires

5. patient is planning to undergo another elective joint procedure during the 6-mo period
of participation;

6. any co-morbidity which results in severe systemic disease limiting function {as
defined by the American Society of Anesthesiology (ASA) physical status classification
> 3}.
We found this trial at
1
site
1653 W. Congress Parkway
Chicago, Illinois 60612
(312) 942-5000
Principal Investigator: Asokumar Buvanendran, MD
Phone: 312-942-2985
Rush University Medical Center Rush University Medical Center encompasses a 664-bed hospital serving adults and...
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Chicago, IL
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