Psychosocial Interventions May Improve Outcomes in Orthopedic Surgery

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The psychosocial interventions that showed the most consistent benefits were patient education and relaxation techniques.
The psychosocial interventions that showed the most consistent benefits were patient education and relaxation techniques.

Psychosocial interventions such as patient education and relaxation techniques may help reduce pain after orthopedic surgery and improve quality of clinical care, according to results published in the Journal of Pain.

The review included 62 randomized controlled clinical trials with 4908 participants. The researchers performed a meta-analysis to examine postoperative pain, analgesic requirement, perioperative anxiety, quality of life, and recovery.

The results indicated that psychosocial interventions led to a reduction in postoperative pain (treatment effect assessed with corrected Hedges' g factor; g, 0.31; 95% CI, 0.14-0.48), preoperative anxiety (g, 0.26; 95% CI, 0.11-0.42), postoperative anxiety (g, 0.4; 95% CI, 0.21-0.59), and recovery (g, 0.38; 95% CI, 0.22-0.54). Psychosocial interventions did not have a significant effect on postoperative analgesic use (g, 0.16; 95% CI, −0.01 to 0.32) or quality of life (g, 0.14; 95% CI, −0.05 to 0.33).

The psychosocial interventions that showed the most consistent benefits were patient education and relaxation techniques, with both interventions having positive effects on pain, anxiety, and recovery. Cognitive and behavioral techniques also showed a beneficial effect on recovery.

"This information can be useful to physicians, healthcare stakeholders, and policy makers alike, and may guide decisions such as whether to employ psychologists to support orthopedic surgeries, or whether to encourage trainings that empower hospital staff to use psychological tools around orthopedic procedures," the researchers wrote.

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Reference

Szeverenyi C, Kekecs Z, Johnson A, et al. The use of adjunct psychosocial interventions can decrease postoperative pain and improve quality of clinical care in orthopedic surgery. A systematic review and meta-analysis of randomized controlled trials [published online May 25, 2018]. J Pain. doi: 10.1016/j.jpain.2018.05.006

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