Trial results for an intervention aimed at preventing persistent post-surgical pain and dysfunction, including associated depression and anxiety, were posted on ClinicalTrials.gov on 2026-05-06. The study, which enrolled 402 participants, investigated Acceptance and Commitment Therapy (ACT) compared to Attention Control (AC) in Veterans undergoing total knee arthroplasty (TKA).
Background
Persistent post-surgical pain and functional limitations are common challenges following major surgeries like total knee arthroplasty (TKA), often accompanied by psychological distress, including anxiety and depression. Effective interventions are needed to improve patient outcomes. Behavioral approaches, such as Acceptance and Commitment Therapy (ACT), aim to enhance coping with pain and improve functioning, offering a potential strategy for post-operative recovery.
Trial design
This completed trial (NCT03965897) enrolled 402 Veterans undergoing total knee arthroplasty (TKA), addressing Pain, Function, Anxiety, and Depression. The primary aim was to assess the superior efficacy of Acceptance and Commitment Therapy (ACT) versus an Attention Control (AC) on postoperative pain intensity and functioning. Outcomes were measured at 6 weeks, 3 months, and 6 months post-TKA, using the Brief Pain Inventory (BPI) Pain Severity Subscale for pain and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for functioning.
Key results
The trial measured pain intensity (lower scores indicate less pain) and function (higher scores indicate better function) at three post-operative time points:
- At 6 weeks post-TKA:
- Pain Intensity: AC mean 4.1 (Standard Deviation 1.95); ACT mean 3.9 (Standard Deviation 2.02).
- Function: AC mean 59.3 (Standard Deviation 20.29); ACT mean 63.4 (Standard Deviation 16.56).
- At 3 months post-TKA:
- Pain Intensity: AC mean 3.9 (Standard Deviation 1.94); ACT mean 3.4 (Standard Deviation 2.11).
- Function: AC mean 65.8 (Standard Deviation 18.81); ACT mean 69.9 (Standard Deviation 17.68).
- At 6 months post-TKA:
- Pain Intensity: AC mean 3.9 (Standard Deviation 2.06); ACT mean 3.9 (Standard Deviation 2.14).
- Function: AC mean 68.9 (Standard Deviation 19.92); ACT mean 70.5 (Standard Deviation 19.67).
What this means
The results suggest that Acceptance and Commitment Therapy (ACT) may improve post-surgical function and, at early and mid-term assessments, reduce pain intensity in Veterans undergoing total knee arthroplasty. The ACT group consistently showed higher mean function scores across all time points and lower mean pain scores at 6 weeks and 3 months compared to the Attention Control group. These findings indicate a potential role for behavioral interventions like ACT in enhancing recovery and managing chronic symptoms after major orthopedic surgery, which could positively impact associated psychological conditions such as depression and anxiety.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for study NCT03965897, titled "Preventing Persistent Post-Surgical Pain and Dysfunction," were posted on 2026-05-06 on clinicaltrials.gov.