Abstract

Objective To evaluate the efficacy of preoperative pain neuroscience education (PNE) on pain intensity, kinesiophobia, catastrophizing, and disability in individuals undergoing hip or knee arthroplasty. Methods A search was conducted on MEDLINE, CINAHL, Epistemonikos, Scopus, and Web of Science from their inception to March 2023. Two investigators independently assessed the risk of bias with Risk of Bias 2 (ROB2) and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) of the studies, as well as the certainty of the evidence with Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) for pain intensity, catastrophizing, kinesiophobia and disability at one month, three months and six months of follow-up. Results A total of 1716 papers were found and two studies on knee arthroplasty were included (n = 147). The intergroup effect sizes for pain intensity were 0.29, 0.07, and 0.25 at one-, three-, and six-months post-surgery, whereas the effect sizes for disability were 0.4, 0.46, and 0.21 (GRADE analysis, moderate certainty, respectively). Catastrophizing showed intergroup effect sizes of 0.78, 1.08, and 0.25, and kinesiophobia of 1.56, 0.92, and 0.33 at follow-up (GRADE analysis, low-moderate certainty). Conclusions Preoperative PNE in individuals undergoing knee arthroplasty has low to moderate certainty for improving pain intensity, catastrophizing, kinesiophobia, and disability with low to high effect sizes and discrepancy between studies. More research on the effect of a preoperative PNE intervention in people undergoing knee or hip arthroplasty is required.