Evidence map›Paper›PMID 41128594›Full record

ArticlePain medicine (Malden, Mass.)2026

Acceptance and commitment therapy for prevention of chronic pain after total knee arthroplasty.

Emanuele Maria Giusti, Gianluca Castelnuovo, Chiara Manna, Giorgia Varallo, Roberto Cattivelli, Benito Vanni Petrachi, Marco Stramba-Badiale, Chiara A M Spatola

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain medicine (Malden, Mass.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05769998 (Development and Improvement of an Acceptance and Commitment-based Treatment for the Prevention of Chronic Pain After Total Knee Arthroplasty), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05769998 naunknown statusnot on this map

Development and Improvement of an Acceptance and Commitment-based Treatment for the Prevention of Chronic Pain After Total Knee Arthroplasty

TypeinterventionalSponsorIstituto Auxologico ItalianoRan2021 to 2024Enrolled210ConditionsKnee OsteoarthritisArmsAcceptance and Commitment-based treatment, Treatment as usual
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Emanuele Maria GiustiEPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy.ORCID 0000-0001-5767-8785
Gianluca CastelnuovoClinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Verbania 28824, Italy.ORCID 0000-0003-2633-9822
Chiara MannaDepartment of Psychology, Catholic University of the Sacred Heart, Milan 20123, Italy.
Giorgia VaralloDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41121, Italy.
Roberto CattivelliDepartment of Psychology, University of Bologna, Bologna 40126, Italy.
Benito Vanni PetrachiDivision of Orthopaedic Surgery, IRCCS Istituto Auxologico Italiano, Milan 20100, Italy.
Marco Stramba-BadialeDepartment of Medicine, Neurology and Rehabilitation, IRCCS Istituto Auxologico Italiano, Milan 20100, Italy.
Chiara A M SpatolaDepartment of Clinical and Experimental Medicine, University of Messina, Messina, Italy.ORCID 0000-0003-4807-9566

Funding

Italian Ministry of Health-Ricerca Corrente
6 · The paper itself

Abstract

objectiveThe aims of this study are to assess the preliminary outcomes of the NOPAIN treatment, which is an acceptance and commitment therapy-based treatment performed in the early postoperative period after total knee arthroplasty (TKA), aimed to prevent the onset of chronic postsurgical pain, as well as to evaluate the predictors of the presence of moderate-to-severe pain after 3 months.

designNon-controlled preliminary trial.

settingDivision of Rehabilitation Medicine within an Italian tertiary care hospital. SUBJECTS: Eighty patients undergoing postoperative rehabilitation after TKA.

methodsBefore the treatment, patients underwent a baseline assessment of pain intensity (Numeric Rating Scale), knee pain, stiffness and function (WOMAC), as well as of potential predictors of the effects of the treatment, namely sex, age, pain duration, catastrophizing (Pain Catastrophizing Scale), psychological distress (Hospital Anxiety and Depression Scale), presence of central sensitization (Central Sensitization Inventory), cognitive flexibility (Wisconsin Card Sorting Test), and heart rate variability. Then, all patients underwent the NOPAIN treatment. Pain intensity, knee pain, stiffness and function, catastrophizing, and psychological distress were also assessed after 3 months.

resultsParticipation rate was 72% and retention was high, with 81.3% of participants completing all 4 sessions of the NOPAIN treatment. Pain intensity (P < .01), knee pain (P < .01), knee stiffness (P < .01), and knee function (P < .01) improved over time. Female sex and age were associated with lower odds of moderate-to-severe pain at 3 months, whereas presence of central sensitization, baseline pain intensity, rumination, helplessness, and changes in helplessness were associated with higher odds.

conclusionThis study shows that the NOPAIN treatment is feasible, that it can be integrated into standard rehabilitative care, and that it might contribute to the prevention of chronic post-surgical pain. The results of this preliminary study will be the basis for the improvement of the intervention. CLINICAL TRIALS REGISTRATION: This preliminary trial is part of a broader research project registered in ClinicalTrials.gov (registration number: NCT05769998, link: https://clinicaltrials.gov/study/NCT05769998). Patient enrolment started on June 15, 2021.

Indexed as

Acceptance and Commitment TherapyArthroplasty, Replacement, KneeChronic PainPostoperative PainAgedCatastrophizationFemaleHumansMaleMiddle AgedPain MeasurementTreatment Outcomeacceptance and commitment therapycentral sensitizationchronic postsurgical painpain catastrophizingpredictors of chronic pain

Identifiers

PMID41128594
PMCPMC13061123

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.