Abstract
PURPOSE: The aim of this study was to determine the influence of preoperative psychological factors on clinical outcomes of fresh osteochondral allograft (FOCA) transplantation of the knee. The hypothesis was that patients with preoperative pathological scores on psychological factors would show worsen functional outcomes after FOCA transplantation of the knee. METHODS: A prospective data collection study was performed from patients undergoing FOCA transplantation for osteochondral lesions of the knee. All patients were followed up for 30 months. Psychological factors of anxiety, depression, kinesiophobia and catastrophizing were assessed by means of self-administered Hospital Anxiety and Depression Subscale (HADS), Tampa Scale for Kinesiophobia (TSK) and Pain Catastrophizing Scale (PCS) questionnaires one week prior to surgery. Clinical outcomes were evaluated preoperatively and at 3, 6, 9, 12, 15 and 30 months postoperatively using the Kujala score, the Western Ontario Meniscal Evaluation Tool (WOMET) score, the International Knee Documentation Committee (IKDC) score and the Tegner Activity Scale. Participants were classified as pathological or non-pathological scores for each psychological parameter in accordance with the cut-off point proposed by the authors of each questionnaire. The interaction between clinical outcome's evolution and pathological scores was analysed using two-way ANOVA tests with Greenhouse-Geisser correction to avoid non-sphericity errors. RESULTS: Forty-one cases were included (mean age 37.1 years old, 41% female). In the postoperative clinical outcome's evolution, no differences were observed between preoperative pathological and non-pathological scores (p > 0.05) regarding anxiety, depression, kinesiophobia and catastrophizing factors. CONCLUSIONS: No significant differences were observed in the evolution of postoperative clinical outcomes between patients with pathological and non-pathological psychological scores. LEVEL OF EVIDENCE: Level III, case series.