Psychological Factors Affecting Rehabilitation and Outcomes Following Elective Orthopaedic Surgery

J Am Acad Orthop Surg. 2015 Sep;23(9):563-70. doi: 10.5435/JAAOS-D-14-00225. Epub 2015 Jul 20.

Abstract

Orthopaedic surgery often requires many months of rehabilitation to achieve a successful outcome, regardless of subspecialty. Several important psychological factors strongly influence pain perceptions, rehabilitation compliance, and patient outcomes after common orthopaedic surgeries that require extensive rehabilitation, including total joint arthroplasty, anterior cruciate ligament reconstruction, and spine surgery for degenerative disease. Early recognition of patients exhibiting psychological distress, fear-avoidance behavior, or poor perceived self-efficacy or pessimistic personality traits can be used to improve preoperative risk stratification for poor rehabilitation or surgical outcomes. Several intervention strategies exist to address these psychological factors when they appear to contribute suboptimal postoperative rehabilitation or recovery.

Keywords: kinesiophobia; pain perception; psychological factors; rehabilitation.

Publication types

  • Review

MeSH terms

  • Avoidance Learning
  • Elective Surgical Procedures / psychology*
  • Elective Surgical Procedures / rehabilitation
  • Humans
  • Orthopedic Procedures / psychology*
  • Orthopedic Procedures / rehabilitation
  • Pain Perception
  • Patient Compliance / psychology
  • Pessimism
  • Postoperative Complications / psychology*
  • Postoperative Complications / rehabilitation
  • Risk Assessment
  • Self Efficacy
  • Stress, Psychological / complications
  • Treatment Outcome