Talking therapy workshop before knee replacement surgery for people with knee osteoarthritis

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults booked for a first, planned total knee replacement who show signs of depression on a questionnaire. It tests a group talking-therapy workshop called Acceptance and Commitment Therapy before surgery.

Age

18 Years to 100 Years

Sex

All sexes can join.

Disease stage

People scheduled for routine primary elective total knee replacement (TKA), a first planned knee replacement.

Earlier treatment

People currently having any other "talking therapy" cannot join.

Biomarker or test result

A score of 10 or more on the Depression part of the DASS-21 questionnaire before surgery.

Main reasons for not taking part

• Planned revision surgery, partial (uni-compartmental) knee replacement, or replacement of both knees.
• No mobile phone for text messages, or no way to answer online questionnaires.
• Surgery date moved by 3 months or more, earlier or later.
• Further bone or joint surgery planned in the next 3 months.
• Not attending the pre-operative education class, or unable to follow the trial schedule.

The registry criteria, word for word

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

• Are you between 18 and 100 years old?YesNo

What the trial wants to find out

Regarding psychosocial factors and outcomes in total knee arthroplasty (TKA), most of the current literature and the investigators' previous work suggest that depression, anxiety and pre-operative pain strongly predict worse outcomes following TKA. Despite some conflicting evidence, on the whole, the current literature suggests that psychological intervention in TKA patients could help to improve outcomes. In recent years, Acceptance and Commitment Therapy (ACT) has been receiving more attention as it may be more effective than the more traditional cognitive behavioural therapy in treating older people with chronic pain. ACT includes a combination of acceptance and mindfulness methods along with activation and behaviour change methods.

The 2 groups in the trial

• Acceptance and Commitment Therapy (ACT)Treatment being tested

  Patients will attend a half-day virtual pre-operative ACT group workshop delivered by physiotherapists. Intervention group patients will also receive booster post-operative ACT text messages once a week for 6 weeks and a telephone follow-up with a physiotherapist at 6-8 weeks. The workshop, text messages and follow-up with a physiotherapist will be in addition to standard care.

  Treatment: Acceptance and Commitment Therapy

• ControlNo study treatment, for comparison

  Patients in the control group will receive standard care; All patients should attend a 1-hour face-to-face group pre-operative education class. Patients in either group will have access to a helpline where they can speak to a nurse to discuss any problems or concerns. All patients will also receive a follow-up phone call from a nurse within 5 days of discharge to check their progress and will attend a 6-12 week follow-up clinic with their surgeon.