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714 - The impact of pre-existing beliefs on post-procedure pain and function in patients receiving intra-articular knee injections for osteoarthritis

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

RS

Ragav Sharma, DO

Resident Physician
The Medial College of Wisconsin
Milwaukee, Wisconsin, United States

Co-Author(s)

WB

Will P. Bataller, MD

Resident Physician
The Medical College of Wisconsin
Milwaukee, Wisconsin, United States
NR

Nathan Rose, n/a

Medical Student
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
CC

Claire Curtis, n/a

Medical Student
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
RR

Ramsey Reyes, MD

Resident Physician
University of California, Irvine
Anaheim, California, United States
HC

Heather Curtiss, MD, MS

Assistant Professor
Medical College of Wisconsin
Milwaukee, Wisconsin, United States

Objectives: In this study, we aim to evaluate the effect of patient pre-existing beliefs using a Modified Fear of Injection Survey (MFIS) on 6-week functional outcome and pain as measured by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire after receiving an intra-articular knee injection (IAKI) for knee osteoarthritis (KOA).

Design: This is a prospective cohort study enrolling patients within the Medical College of Wisconsin and Affiliated Hospitals (MCWAH) system. Included participants were over the age of 18 and had KOA. They were excluded if they were unable to complete an electronic survey, IAKI within the last 3 months, history of lower limb trauma, joint deformity, confounding medical diagnosis, or were considered for total knee arthroplasty. Participants who met criteria were screened by phone call one week prior to their appointment. Those who consented to the study were emailed a modified fear of injection survey (MFIS) and instructed to complete a post-visit survey that included the Western Ontario and McMaster Universities Arthritis Index (WOMAC) six weeks after their appointment.

Results: ~2000 charts were screened with 818 charts meeting study criteria. Ultimately, 112 participants were included in the analysis. Average BMI for all participants was 33.6 and the average age was 67.6. Analysis using linear regression revealed a statistically significant relationship between expected treatment results question of the MFIS and total WOMAC score (𝛃=-4.5, p< 0.05) as well as between expected treatment results and the WOMAC function subscale (𝛃=-2.8, p< 0.05).

Conclusions: This study demonstrates that pre-existing beliefs do impact both overall WOMAC and WOMAC functional subscores in patients with KOA. Positive beliefs about IAKI may predict low WOMAC scores and thus a better outcome. Pre-screening patients undergoing IA may be useful to clinicians to tailor their therapeutic approach for patients with KOA.