O papel da catastrofização da dor no prognóstico e tratamento de idosos com osteoartrite de joelho: uma revisão crítica da literatura

Abstract

With the aging population, there will be an increased prevalence of chronic degenerative diseases, among them the osteoarthritis (OA). The most effective procedure for patients with severe knee OA who have not responded to conservative treatment is surgical treatment, which the most common is a total knee arthroplasty (TKA). Studies show that this surgery can lead to a significant reduction in pain and improvement in functional abilities and quality of life, but some people have negative results against this procedure. The pain catastrophizing, which is a negative orientation to certain painful stimulus, has been identified as the most important psychological predictor for worse outcomes after TKA. Thus, the aim of this study was to review the literature regarding the influence of pain catastrophizing in the prognosis and treatment of elderly peoples with knee osteoarthritis. It was performed a literature search in Medline / PubMed, SciELO, LILACS, and Google Scholar from the first record until june 2012. The search yielded a total of 2218 articles and, after the analysis, it was included six articles. According to the findings, all items showed that despite the analysis of other variables such as depression, anxiety, pain severity, disability, stiffness, expectations and comorbidities, only pain catastrophizing was found to be the variable that contributes significantly to the results recovery after TKA, or worse scores on scales that assess catastrophizing as, for example, the PCS (Scale of Pain Catastrophizing) are related to longer hospital stays, more pain and deterioration in functionality after TKA. Thus, with basic measures such as the identification of individuals that catastrophize more, the recovery time of individuals and the costs of the pre and post-surgical procedure can be reduced, thereby improve the quality of life of the elderly people who need to go through this intervention.