Effects of empowered relief on pain catastrophizing and outcomes post-total knee arthroplasty: A quasi-experimental study.

Patients were not randomly assigned. They went into groups according to the dates they had surgery, which the authors accept risks selection bias and limits how far the results can be relied on. Only 64 people from one hospital in China were analysed, and almost all had junior high school education or less, so the findings may not transfer to other patients or services. Only patients who completed follow-up were analysed and the missing data were simply dropped, which can bias the results. Follow-up stopped at three months, so nothing is known about longer-term effects. The intervention was a package: education, relaxation training, positive self-talk and imagery, distraction, a personal pain-relief plan, and daily WeChat reminders with continued contact from the research team. The control group had one-off education with no follow-up support. There is no way to tell which part of the package did the work, or how much of the difference came from the extra attention and contact. The authors did not calculate an effect size, so the size of the benefit is hard to judge. People with any other psychiatric or psychological disorder, cognitive impairment, a history of opioid abuse, or pain from another cause were excluded, so the results do not speak to them.

The authors declare no conflict of interest. The work was funded by three Chinese regional programmes: the Scientific and Technological Innovation Programme of Lanzhou (CY2022-HL-B02), the Innovation Fund for Higher Education of Gansu Province (2022B-045), and the 2024 Gansu Provincial Health Industry Science and Technology Programme (GSWSQN 2024-12). The paper does not say what role, if any, the funders had in the study.

Do not read this as proof that a pre-surgery Empowered Relief session reduces pain after knee replacement. Patients were not randomly assigned to their groups, the study was small and from a single hospital, and the intervention group also received daily reminders and ongoing contact that the control group did not, so part of the difference may not come from the session itself. Painkiller use after discharge was the same in both groups, so the session did not translate into fewer or lower-dose painkillers.