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Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury

Author

Listed:
  • Grant H. Cabell

    (Department of Orthopaedic Surgery, Duke University Medical Center, 3475 Erwin Rd., Durham, NC 27705, USA)

  • Billy I. Kim

    (Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA)

  • Kevin A. Wu

    (School of Medicine, Duke University, Durham, NC 27710, USA)

  • Emily J. Luo

    (School of Medicine, Duke University, Durham, NC 27710, USA)

  • Clark Bulleit

    (School of Medicine, Duke University, Durham, NC 27710, USA)

  • Nicholas J. Morriss

    (Department of Orthopaedic Surgery, University of Rochester Medical Center, 10 Miracle Drive, Rochester, NY 14623, USA)

  • Trevor A. Lentz

    (Department of Orthopaedic Surgery, Duke University Medical Center, 3475 Erwin Rd., Durham, NC 27705, USA
    Duke Clinical Research Institute, Duke University, 3475 Erwin Rd., Durham, NC 27705, USA)

  • Brian C. Lau

    (Department of Orthopaedic Surgery, Duke University Medical Center, 3475 Erwin Rd., Durham, NC 27705, USA)

Abstract

(1) Background: Pain experiences are shaped by both physical injury and psychological distress, posing challenges for orthopedic care. While surgery may alleviate injury-related distress, the extent of psychological improvement post surgery remains unclear. Thus, the purpose of this study was to evaluate changes in general and pain-specific psychological distress after surgical intervention for musculoskeletal injury. (2) Methods: A retrospective review was conducted on 133 patients who underwent musculoskeletal surgery between February 2020 and August 2022 by a single sports medicine fellowship-trained surgeon. Psychological distress was assessed using the Optimal Screening for Prediction of Referral and Outcome Yellow-Flag (OSPRO-YF) tool, both before and at least six months after surgery. Pre- and postoperative scores were compared using paired t -tests, and clinically meaningful changes were evaluated using a distribution-based minimal clinically important difference (MCID) threshold. (3) Results: Significant reductions were found in total OSPRO-YF scores and several subdomains including fear avoidance (physical activity and work), kinesiophobia, and pain anxiety. However, 88% of patients showed no meaningful change in overall psychological distress. In patients with high baseline distress, over 20% showed meaningful improvement in six subdomains. (4) Conclusions: Psychological distress often persists after musculoskeletal surgery. Targeted psychological interventions may benefit patients with high preoperative distress.

Suggested Citation

  • Grant H. Cabell & Billy I. Kim & Kevin A. Wu & Emily J. Luo & Clark Bulleit & Nicholas J. Morriss & Trevor A. Lentz & Brian C. Lau, 2025. "Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury," IJERPH, MDPI, vol. 22(6), pages 1-12, May.
  • Handle: RePEc:gam:jijerp:v:22:y:2025:i:6:p:857-:d:1668497
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