ArticlesThe role of presurgical expectancies in predicting pain and function one year following total knee arthroplastySullivan, Michaela,*; Tanzer, Michaelb; Reardon, Geraldc; Amirault, Davidc; Dunbar, Michaelc; Stanish, WilliamcAuthor Information aDepartment of Psychology, McGill University, Montreal, QC, Canada bDepartment of Surgery, McGill University, Montreal, QC, Canada cDepartment of Surgery, Dalhousie University, Halifax, NS, Canada *Corresponding author. Address: Department of Psychology, McGill University, 1205 Docteur Penfield, Montreal, Quebec, Canada H3A 1B1. E-mail address:[email protected] Submitted January 10, 2011; revised May 30, 2011; accepted June 10, 2011. Pain: October 2011 - Volume 152 - Issue 10 - p 2287-2293 doi: 10.1016/j.pain.2011.06.014 Buy Metrics Abstract Summary Patients’ behavioral outcome expectancies assessed presurgically predicted pain severity and physical function 1 year after total knee arthroplasty (TKA) and partially mediated the relation between catastrophizing and TKA outcomes. The present study examined the prospective value of response expectancies (ie, pain, sleep) and behavioral outcome expectancies (ie, return to function) in the prediction of pain severity and functional limitations 12 months after total knee arthroplasty (TKA). The study sample consisted of 120 individuals (73 women, 47 men) with osteoarthritis of the knee who were scheduled for TKA. Measures of expectancies, pain severity, pain catastrophizing, pain-related fears of movement, and depression were completed prior to surgery. Participants also completed measures of pain severity and functional limitations 12 months following surgery. Analyses revealed that behavioral outcome expectancies were stronger predictors of follow-up pain and functional limitations than response expectancies. Consistent with previous research, analyses also revealed that pain catastrophizing, pain-related fear of movement, and depression predicted follow-up pain and function. In a multivariate analysis, only pain catastrophizing contributed significant unique variance to the prediction of follow-up pain and function. Behavioral outcome expectancies partially mediated the relation between catastrophizing and follow-up pain and function. The relation between catastrophizing and follow-up pain severity and functional limitations remained significant even when controlling for behavioral outcome expectancies. The results suggest that interventions designed to specifically target behavioral outcome expectancies and catastrophizing might improve post-surgical outcomes. © 2011 Lippincott Williams & Wilkins, Inc.