ArticleActa orthopaedica2025
Fear avoidance and catastrophizing are associated with both knee awareness and quality of life in knee osteoarthritis patients: a secondary report of a cross-sectional study.
Article in Acta orthopaedica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03771430 (A Multidisciplinary Intervention in Total Knee Arthroplasty - a Multicenter, Randomized Controlled Trial in OA Patients), which is not on this map. Cited by 2 papers.
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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.
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.
A Multidisciplinary Intervention in Total Knee Arthroplasty - a Multicenter, Randomized Controlled Trial in OA Patients (The MultiKnee Trial)
Who cites it
2 citing papers in PubMed.
- Effects of Using High-Frequency TENS During an Exercise Therapy Program in Knee Osteoarthritis: A Randomized Sham-Controlled Trial.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026Trial
- Psychological factors associated with trial participation among patients eligible for total knee arthroplasty with a non-surgical treatment arm: a comparative cross-sectional study.Acta orthopaedica · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeIn patients with knee osteoarthritis (OA), psychological factors (anxiety, depression, and pain-related catastrophizing) are associated with more pain and worse physical function. Low knee awareness and high knee-related quality of life (QoL) are key indicators of a well-functioning knee. The objective of our study was to evaluate associations between psychological factors and knee awareness and knee-related QoL in patients with knee OA.
methodsIn this Norwegian cross-sectional study of 653 patients with knee OA, 4 psychological factors were assessed: anxiety, depression, pain-related catastrophizing, and fear avoidance of physical activity. Associations between these factors and knee awareness and knee-related QoL were examined in unadjusted and adjusted regression models, controlling for age, sex, BMI, pain, and whether patients accepted or declined inclusion in a randomized controlled trial (ClinicalTrials.gov: NCT03771430). Regression coefficients with values below zero indicate negative associations between the independent and dependent factors and values above zero indicate positive associations.
resultsWorse scores on all 4 psychological measures were associated with higher knee awareness and poorer knee-related QoL in unadjusted analyses. Standardized estimates (βs) ranged from -0.38 (95% confidence intervals [CI] -0.45 to -0.31) to -0.16 (CI -0.23 to -0.08). In adjusted analyses, pain catastrophizing (β -0.07, CI -0.14 to -0.01) and fear-avoidance (β -0.11, CI -0.18 to -0.05) remained associated with higher knee awareness, whereas poorer knee-related QoL remained associated with more anxiety (β -0.10, CI -0.16 to -0.03) and depression (β -0.14, CI -0.20 to -0.08), as well as more pain catastrophizing (β -0.19, CI -0.26 to -0.12) and fear-avoidance (β -0.19, CI -0.25 to -0.13).
conclusionHigher fear avoidance of physical activity and more pain catastrophizing had the strongest associations with higher knee awareness and poorer knee-related QoL.
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