Relationship Between Pain Catastrophizing and 6-Month Outcomes Following Anterior Cruciate Ligament Reconstruction.

Journal Article (Multicenter Study;Journal Article)


Pain catastrophizing predicts poor outcomes following orthopedic procedures for patients with chronic conditions; however, limited research has focused on acute injuries. This study aimed to quantify the progression of Pain Catastrophizing Scale (PCS) scores from injury to 6-months post-anterior cruciate ligament reconstruction (ACLR) and determine if preoperative or 6-month PCS scores were related with self-reported pain or function 6 months post-ACLR. The authors hypothesized PCS scores would minimally fluctuate and would be related with worse outcomes 6-months post-ACLR.


All 48 participants (27 male/21 female; aged 22.7 [4.6] y, body mass index 24 [3.3]) included in this secondary analysis of a randomized control trial sustained an ACL injury during sports activity. Participants completed the PCS and Pain Visual Analog Scale (VAS) at 5 time points: within 7 days of injury (INITIAL), day of surgery, 2 weeks postoperative (2W), 6 weeks postoperative (6W), and 6 months postoperative (6M). They completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6M. Wilcoxon signed-rank tests and Spearman rank-order correlations were used for analysis.


PCS scores were not fixed (INITIAL: 11.6 [10.8], day of surgery: 2.5 [3.7], 2W: 8.0 [7.8], 6W: 3.7 [6], 6M: 0.8 [2.3]). They fluctuated in response to injury and ACLR similar to Pain VAS scores. Preoperative PCS scores were not related with 6M outcomes; however, 6M PCS scores were significantly related with 6M Pain VAS and KOOS subscales.


PCS scores fluctuated in response to injury and ACLR. Preoperative PCS scores were not related with 6M outcomes; however, 6M PCS scores correlated with pain and function at 6M. High pain catastrophizing appears to be a natural response immediately following acute ACL injury and ACLR, but may not be indicative of a poor postoperative result. PCS scores 6-months following ACLR may provide useful information regarding self-reported pain and function.

Full Text

Duke Authors

Cited Authors

  • Jochimsen, KN; Pelton, MR; Mattacola, CG; Huston, LJ; Reinke, EK; Spindler, KP; Lattermann, C; Jacobs, CA

Published Date

  • August 2020

Published In

Volume / Issue

  • 29 / 6

Start / End Page

  • 808 - 812

PubMed ID

  • 31628272

Electronic International Standard Serial Number (EISSN)

  • 1543-3072

International Standard Serial Number (ISSN)

  • 1056-6716

Digital Object Identifier (DOI)

  • 10.1123/jsr.2018-0431


  • eng