• Julio Doménech, Vicente Sanchis-Alfonso, and Begoña Espejo.
• Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, C/San Clemente #12, 46015, Valencia, Spain.
• Knee Surg Sports Traumatol Arthrosc. 2014 Oct 1;22(10):2295-300.

PurposeThe purpose of the study was to investigate if changes in psychological variables are related to the outcome in pain and disability in patients with chronic anterior knee pain.MethodsA longitudinal observational study on 47 patients with chronic anterior knee pain was performed in a secondary healthcare setting. Pain was measured with the visual analogue scale and disability with the Lysholm scale. The psychological variables, such as anxiety, depression, pain coping strategies, catastrophizing and fear to movement beliefs, were studied by using self-administered questionnaires.ResultsAmong the pain coping strategies, only the catastrophizing subscale showed a significant reduction. Similarly, anxiety, depression and kinesiophobia were significantly reduced after treatment. Those patients who decreased the catastrophizing, kinesiophobia, anxiety and depression showed a greater improvement in pain and disability after a purely biomedical treatment. A multiple regression analysis revealed that changes in catastrophizing predicted the amount of improvement in pain severity and that changes in both catastrophizing and anxiety predicted changes in disability after treatment.ConclusionWhat has been found suggests that clinical improvement in pain and disability is associated with a reduction in catastrophizing and kinesiophobia. Therefore, co-interventions to reduce catastrophizing thinking and kinesiophobia may enhance the results.Level Of EvidenceProspective Cohort Study, Level I for prognosis.

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