Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Setting and Cohort
2.2. Study Tools
2.3. Statistical Analysis
3. Results
Exploratory Analysis of Those with High Preoperative Distress
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Psychological Domain | Example Item (Paraphrased) | Response Range |
---|---|---|
Negative Mood | “I am hot-headed” | 1–4 (Almost never–Almost always) |
Poor Coping | “I can’t stop thinking about my pain” “I refrain from activities that may aggravate my pain” | 0–4 (Not at all–All the time) 0–6 (Completely disagree–Completely agree) |
Positive Affect | “I live a full life despite chronic pain” “My emotional state does not deter me from performing therapy” | 0–4 (Never true–Always true) 0–10 (I can’t do it–I can do it) |
Overall | |
---|---|
N | 133 |
Age in years, mean (sd) | 49.0 (17.2) |
Gender, n (%) | |
Male | 59 (44.4) |
Female | 74 (56.6) |
Race, n (%) | |
White | 94 (70.7) |
Black/AA | 28 (21.1) |
Mixed/Other/Not Reported | 11 (8.3) |
ASA, mean (sd) | 2.19 (0.62) |
BMI, mean (sd) | 29.91 (6.71) |
Current Smoker, n (%) | 5 (3.8) |
Laterality = Right, n (%) | 61 (45.9) |
Anatomic Location of Surgery, n (%) | |
Femur/Knee | 72 (54.1) |
Foot/Toes | 1 (0.8) |
Humerus/Elbow | 2 (1.5) |
Leg/Ankle | 8 (6.0) |
Other MSK | 4 (3.0) |
Pelvis/Hip | 1 (0.8) |
Shoulder | 45 (33.8) |
CPT Code Category | |
Femur/Knee Arthroscopy | 61 (45.9) |
Femur/Knee Excision | 1 (0.8) |
Femur/Knee Repair/Revision/Reconstruction | 10 (7.5) |
Foot/Toes Fracture and/or Dislocation | 1 (0.8) |
Humerus/Elbow Repair/Revision/Reconstruction | 2 (1.5) |
Leg/Ankle Arthroscopy | 2 (1.5) |
Leg/Ankle Fracture and/or Dislocation | 2 (1.5) |
Leg/Ankle Incision | 1 (0.8) |
Leg/Ankle Repair/Revision/Reconstruction | 3 (2.3) |
Other MSK Intro or Removal | 4 (3.0) |
Pelvis/Hip Fracture and/or Dislocation | 1 (0.8) |
Shoulder Arthroscopy | 42 (31.6) |
Shoulder Fracture and/or Dislocation | 2 (1.5) |
Shoulder Repair/Revision/Reconstruction | 1 (0.8) |
Preop | Postop | Mean Difference | T-Statistic | p-Value * | |
---|---|---|---|---|---|
N | 133 | 133 | |||
OSPRO Total Score, mean (sd) | 20.0 (7.9) | 18.5 (8.6) | −1.44 | −2.24 | 0.027 |
PHQ9, mean (sd) | 5.2 (4.1) | 4.8 (4.6) | −0.33 | −0.86 | 0.390 |
STAI, mean (sd) | 36.1 (7.9) | 35.7 (8.6) | −0.46 | −0.73 | 0.466 |
STAXI, mean (sd) | 15.2 (3.3) | 15.0 (3.7) | −0.29 | −1.27 | 0.207 |
FABQPA, mean (sd) | 16.4 (4.8) | 13.5 (5.0) | −2.89 | −5.33 | <0.001 |
FABQW, mean (sd) | 16.3 (11.5) | 13.1 (10.7) | −3.22 | −3.09 | 0.002 |
PCS, mean (sd) | 16.1 (9.5) | 14.7 (10.1) | −1.40 | −1.52 | 0.132 |
TSK11, mean (sd) | 24.7 (5.8) | 22.8 (6.0) | −1.88 | −3.25 | 0.001 |
PASS20, mean (sd) | 30.8 (14.9) | 27.8 (15.8) | −3.00 | −2.24 | 0.027 |
PSEQ, mean (sd) | 35.6 (10.6) | 36.8 (11.5) | 1.12 | 1.21 | 0.230 |
SER, mean (sd) | 88.9 (19.4) | 87.1 (21.4) | −1.86 | −0.99 | 0.324 |
CPAQ, mean (sd) | 63.3 (15.5) | 65.0 (16.3) | 1.66 | 1.26 | 0.208 |
Meaningful Decrease | No Meaningful Change | Meaningful Increase | |
---|---|---|---|
Meaningful Change (1.5 × SD) in Questionnaire Score Estimates | |||
OSPRO Total Score | 10 (7.5) | 117 (88.0) | 6 (4.5) |
PHQ9 | 10 (7.5) | 117 (88.0) | 6 (4.5) |
STAI | 6 (4.5) | 123 (92.5) | 4 (3.0) |
STAXI | 6 (4.5) | 122 (91.7) | 5 (3.8) |
FABQPA | 30 (22.6) | 95 (71.4) | 8 (6.0) |
FABQW | 15 (11.3) | 112 (84.2) | 6 (4.5) |
PCS | 17 (12.8) | 107 (80.5) | 9 (6.8) |
TSK11 | 17 (12.8) | 108 (81.2) | 8 (6.0) |
PASS20 | 15 (11.3) | 111 (83.5) | 7 (5.3) |
PSEQ | 4 (3.0) | 117 (88.0) | 12 (9.0) |
SER | 10 (7.5) | 113 (85.0) | 10 (7.5) |
CPAQ | 5 (3.8) | 116 (87.2) | 12 (9.0) |
Meaningful change (1.5 × SD) in patients presenting with YF for each questionnaire | |||
PHQ9 | 10 (27.8) | 25 (69.4) | 1 (2.8) |
STAI | 6 (14.6) | 34 (82.9) | 1 (2.4) |
STAXI | 5 (12.2) | 36 (87.8) | 0 (0.0) |
FABQPA | 26 (34.7) | 49 (65.3) | 0 (0.0) |
FABQW | 15 (20.5) | 54 (74.0) | 4 (5.5) |
PCS | 17 (32.1) | 32 (60.4) | 4 (7.5) |
TSK11 | 17 (21.0) | 61 (75.3) | 3 (3.7) |
PASS20 | 14 (22.2) | 46 (73.0) | 3 (4.8) |
PSEQ | 2 (2.4) | 68 (82.9) | 12 (14.6) |
SER | 4 (5.6) | 58 (80.6) | 10 (13.9) |
CPAQ | 4 (5.6) | 56 (77.8) | 12 (16.7) |
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Cabell, G.H.; Kim, B.I.; Wu, K.A.; Luo, E.J.; Bulleit, C.; Morriss, N.J.; Lentz, T.A.; Lau, B.C. Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury. Int. J. Environ. Res. Public Health 2025, 22, 857. https://doi.org/10.3390/ijerph22060857
Cabell GH, Kim BI, Wu KA, Luo EJ, Bulleit C, Morriss NJ, Lentz TA, Lau BC. Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury. International Journal of Environmental Research and Public Health. 2025; 22(6):857. https://doi.org/10.3390/ijerph22060857
Chicago/Turabian StyleCabell, Grant H., Billy I. Kim, Kevin A. Wu, Emily J. Luo, Clark Bulleit, Nicholas J. Morriss, Trevor A. Lentz, and Brian C. Lau. 2025. "Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury" International Journal of Environmental Research and Public Health 22, no. 6: 857. https://doi.org/10.3390/ijerph22060857
APA StyleCabell, G. H., Kim, B. I., Wu, K. A., Luo, E. J., Bulleit, C., Morriss, N. J., Lentz, T. A., & Lau, B. C. (2025). Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury. International Journal of Environmental Research and Public Health, 22(6), 857. https://doi.org/10.3390/ijerph22060857