ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Anxiety and Stress Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1556829
This article is part of the Research TopicBidirectional Links Between Psychological Trauma and Physical Symptoms: Pathophysiology, Diagnosis, Prevention, and TreatmentView all 8 articles
Post-Traumatic Growth Trajectories and Influencing Factors in Patients Undergoing Hip and Knee Arthroplasty: A Prospective Longitudinal Study
Provisionally accepted
- 1Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 2Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
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Background: Total hip/knee arthroplasty (THA/TKA) has emerged as the gold-standard treatment for end-stage osteoarthritis. However, persistent postoperative pain and surgical trauma often induce psychological distress, complications that are frequently overlooked despite high procedural success rates. Leveraging Post-Traumatic Growth (PTG) theory, this study longitudinally investigated PTG levels. Through multidimensional analysis of predictive factors, we can provide an evidence-based framework for psychological interventions to accelerate rehabilitation.Methods: This prospective longitudinal study enrolled 160 arthritis patients (79 with hip involvement and 81 with knee involvement). In addition to collecting demographic and diseaserelated data, we administered the following instruments at four time points-one day preoperatively (T1), one day postoperatively (T2), one month postoperatively (T3), and three months postoperatively (T4): the Post-Traumatic Growth Inventory (PTGI), the General Self-Efficacy Scale (GSES), the Perceived Social Support Scale (PSSS), the Medical Coping Modes Questionnaire (MCMQ), the Harris Hip Score (HHS), and Knee Society Score (KSS).Univariate analysis combined with hierarchical regression was used to explore factors influencing PTGI scores.Results: PTG scores showed a statistically significant nonlinear progression characterized by: preoperative day 1 (27.23 ± 12.87), postoperative day 1 (48.61 ± 14.49), postoperative month 1 (42.87 ± 12.72), and postoperative month 3 (64.37 ± 9.42). Housing type (T1, T2, T4), arthritis location (T1), surgical site (T2), complications (T4), comorbidities (T1), and joint function (T1-T4) were significant predictors of PTG (P < 0.05). Self-efficacy was positively correlated with PTG at T1 and T2 (P < 0.05). Coping strategies, such as "facing" (T1, T4), were positively correlated with PTG, while "avoidance" (T1, T2, T4) and "yielding" (T1) showed negative correlations (P < 0.05). Family support (T2, T3) was positively correlated with PTG (P < 0.05).The PTG scores in THA/TKA patients demonstrated a curvilinear upward trajectory over time, maintaining moderate to low overall levels. Notably, the 1-month postoperative period emerged as a critical window for targeted interventions. Joint function, self-efficacy, proactive coping strategies, and social support significantly enhanced PTG levels, whereas yield-avoidant coping strategies showed negative correlations with PTG scores.Healthcare providers should monitor multidimensional factors influencing PTG variations across different time points, formulating evidence-based health education programs and personalized interventions to accelerate rehabilitation processes.
Keywords: hip arthroplasty, knee arthroplasty, Post-traumatic growth, Influencing factors, social support, self-efficacy, coping strategy
Received: 07 Jan 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Xie, Fu, Li, Chen, Zhang, Li, Ning and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ning Ning, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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