title: The Videoinsight®Method: improving early results following total knee arthroplasty.
abstract: OBJECTIVE
  The purpose of this randomized double-blind study was to investigate the effectiveness of the Videoinsight®psychological enhancing method in promoting early recovery during rehabilitation following total knee arthroplasty.
  
  
  METHODS
  One-hundred and ten patients treated with cemented total knee arthroplasty were randomly assigned to Group A or Group B, and both groups underwent the same rehabilitation programme. Group A (55 patients) received one art video selected according to Videoinsight®concept. This art video promoting self-confidence and psychological support to the patient has been shown in the physical therapy department before any rehabilitation session, in the first 15 days after surgery and then three times a week for the next 4 weeks. Group B (55 patients) underwent the same rehabilitation protocol in the same setting, after TKA surgery, without the video support. Patients were evaluated pre-operatively and 3 months after surgery with Physical and Mental SF-36, State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Tampa Scale of Kinesiophobia (TSK), Knee Society Score (KSS), VAS, and WOMAC scores.
  
  
  RESULTS
  Eight patients were lost to follow-up, and 102 patients (Group A: 52 patients; Group B: 50 patients) were available at mean 3.0 ± 0.2 months follow-up. Age at surgery was 69.1 ± 13.0 years. The two groups were homogeneous regarding pre-operative demographic data and clinical outcomes. Significant improvements were observed in both groups compared to baseline and in Group A compared to Group B at final follow-up for functional and psychological scores except for SF-36. Respectively, Group A and Group B showed WOMAC 79.9 ± 13.0 and 69.7 ± 9.5 (p < 0.005), VAS 2.8 ± 1.6 and 4.0 ± 1.5, (p < 0.005), KSS 87.8 ± 9.6 and 78.3 ± 8.2 (p < 0.005), BDI 5.1 ± 4.8 and 9.4 ± 3.9 (p < 0.005), STAI 30.8 ± 7.9 and 34.8 ± 7.8 (p < 0.005), and TSK 24.4 ± 5.5 and 29.3 ± 4.8 (p < 0.005).
  
  
  CONCLUSIONS
  The Videoinsight(®) psychological enhancing method, by the view of video art images, combined to an adequate rehabilitation protocol can be a means for further improving short-term clinical and functional outcomes by giving a psychological support to patients who underwent total knee arthroplasty.
  
  
  METHODS
  I.
authors.affiliation: Videoinsight® Center, via F. Bonsignore 7, 10131, Turin, Italy.
authors.forename: Luciana Rebecca
authors.initials: LR
authors.lastname: Russo
authors.affiliation: Medicina Fisica e Riabilitativa, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Benedetti
authors.affiliation: Medicina Fisica e Riabilitativa, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Mariani
authors.affiliation: Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136, Bologna, Italy. tommaso.robertidisarsina@hotmail.com.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Roberti di Sarsina
authors.affiliation: Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007092:Imagination / Q000502:physiology*; D008297:Male; D009068:Movement / Q000502:physiology*; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery; D063868:Patient Outcome Assessment; D020377:Self Efficacy; D014741:Video Recording
keywords: Catastrophizing; Kinesiophobia; Psychological support; Psychology; Rehabilitation; Total knee arthroplasty; Videoinsight® Method