title: Patient's personality predicts recovery after total knee arthroplasty: a retrospective study.
abstract: BACKGROUND
  Increasing attention to psychological determinants may be useful in identifying patients undergoing total knee arthroplasty who may be at risk for poor postoperative outcome. However, little is known about the relationship between personality as a comprehensive reflection of stable psychological states and outcome after total knee arthroplasty. The purpose of this study was to describe the relationship between patients' diverse personalities and clinical outcomes.
  
  
  METHODS
  We recruited 387 patients undergoing primary total knee arthroplasty to complete the Eysenck Personality Questionnaire (EPQ) and collected demographic information before surgery. Prior to and 6 months after surgery, we used two validated functional instruments to assess satisfaction rate-the Short Form Health Survey of 36 questions (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
  
  
  RESULTS
  Neuroticism, especially the classic type, tended to be displayed more frequently by women and younger patients. A statistically significant positive relationship was seen between outcome scores and extraversion levels in rating scales; there was a negative relationship between outcome scores especially from the SF-36 Mental Component Summary (MCS), WOMAC pain scores, and neuroticism subscales scores. Among four types of personality, sanguine patients displayed the best clinical outcomes and melancholic patients the worst. Despite good clinical outcomes, including in pain relief and functional improvement for choleric patients, satisfaction rate was unexpectedly the lowest.
  
  
  CONCLUSIONS
  Our results may help clinicians identify patients at risk for poor postoperative clinical outcomes and thus proceed with better communication with patients. Also, our results may indicate conducting individual attention during the perioperative period based on patient personality determined according to the EPQ in order to help attain better recovery.
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China.. Electronic address: Gonglong301@163.com.
authors.forename: Long
authors.initials: L
authors.lastname: Gong
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China.. Electronic address: Dongjiyuan81301@163.com.
authors.forename: Ji-Yuan
authors.initials: JY
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction; D010551:Personality; D011184:Postoperative Period; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult