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Brief Mindfulness-based Cognitive Behavioral Therapy is Associated with Faster Recovery in Patients Undergoing Total Knee Arthroplasty: A Pilot Clinical Trial.

Pain Medicine 2022 November 18
OBJECTIVE: To assess whether brief mindfulness-based cognitive behavioral therapy (MBCBT) could enhance the benefits of total knee arthroplasty (TKA) in improving pain and pain-related disability. Specifically, to determine (1) whether patients who received MBCBT differed from matched controls who received treatment as usual (TAU) on post-surgical pain outcomes, and (2) whether changes in pain catastrophizing, depression, and/or anxiety explained the potential effects of MBCBT on pain outcomes.

DESIGN: Pilot clinical trial.

SUBJECTS: Sample of 44 patients undergoing TKA. Patients who completed a brief MBCBT intervention (n = 22) were compared with age-, race-, and sex-matched controls who received TAU (n = 22).

METHODS: The MBCBT intervention included 4, 60-minute sessions delivered by a pain psychologist in-person and via telephone during the perioperative period. Participants were assessed at baseline, 6 weeks, 3 months, and 6 months post-surgery.

RESULTS: Compared to matched controls, patients who received MBCBT had lower pain severity and pain interference at 6-week post-surgery. Group differences in outcomes were mediated by changes in pain catastrophizing, but not by changes in depression or anxiety. The MBCBT group had similar reductions in pain severity and interference as the control group at 3- and 6-month post-surgery.

CONCLUSIONS: This work offers evidence for a safe and flexibly delivered nonpharmacological treatment (MBCBT) to promote faster recovery from TKA and identifies change in pain catastrophizing as a mechanism by which this intervention may lead to enhanced pain-related outcomes.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT04328701) https://clinicaltrials.gov/ct2/show/NCT04328701?term=NCT04328701&draw=2&rank=1.

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