Background: Approximately, 20% of patients with osteoarthritis and underwent a total knee arthroplasty (TKA) experience high levels of pain and disability after surgery. Literature shows that preoperative pain catastrophism is one of the most relevant predictors for poor outcomes following TKA, and it might be an important treatment target before surgery. Pain neuroscience education (PNE) and coping skills training (CST) have shown to improve pain catastrophism levels on chronic pain patients. 
This randomized single-blind controlled pilot study aimed to compare the effects of a perioperative treatment based on PNE and CST to improve knee pain, physical performance and psychosocial outcomes of patients with knee osteoarthritis and pain catastrophism scheduled for TKA. 

Methods: Eleven patients with knee osteoarthritis and high levels of pain catastrophism were randomly allocated to receive both PNE and CST (n= 5) or only usual care (n=6). Self-administered questionnaires and physical tests were provided at baseline, 3 and 6 months after surgery.

Results: No statistically significant differences were observed between groups at baseline. At 6 months assessment, statistically significant differences were observed between groups for physical performance, pain catastrophism, depression, anxiety, self-efficacy and coping strategy of distraction. No significant differences were found in pain, disability, quality of life and Kinesiophobia.

Conclusion: Our results suggest that patients receiving PNE and CST showed more significant improvements in physical performance and psychosocial variables (pain catastrophism, depression, anxiety, self-efficacy and coping strategy of distraction).

EFFECTIVENESS OF PAIN NEUROSCIENCE EDUCATION AND COPING SKILLS TRAINING FOR PATIENTS WITH PAIN CATASTROPHISM SCHEDULED FOR A TOTAL KNEE ARTHROPLASTY: RANDOMIZED CONTROLLED PILOT STUDY