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Is trait mindfulness associated with pain interference in patients undergoing total knee arthroplasty? A prospective cohort study.

William Egan, Patricia Crane, John C. Morris, Jodi L Young, Daniel I Rhon

Physiotherapy Theory and Practice April 13, 2026 DOI: 10.1080/09593985.2026.2656341 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Prospective cohort study Peer reviewed
Sample size 248
Population Patients undergoing total knee arthroplasty in the Bellin Health System during 2022 (59% female, mean age 66.4 years)
Duration 12-week postoperative follow-up
Measures Mindfulness Attention Awareness Scale (MAAS)
Topics Meditation
Keywords Opioids Physical function Total knee arthroplasty Pain interference
Key findings Higher baseline trait mindfulness (MAAS) was associated with lower pain interference and better physical function at baseline but not with opioid use. Baseline MAAS scores did not significantly predict pain, function, or opioid use at 12 weeks postoperatively, suggesting trait mindfulness may relate to outcomes at assessment but not longer-term recovery.

Abstract

Introduction: About 20% of individuals undergoing total knee arthroplasty (TKA) report ongoing pain and poor function. Trait mindfulness - a person's inherent ability to be attentive to the present - has been linked to reduced pain in other conditions but not yet studied in TKA.

Objective: This study examined whether higher trait mindfulness was associated with less pain interference at baseline and 12 weeks post-TKA. Secondary aims included associations with physical function and opioid use at 12 weeks.

Methods: This prospective cohort study included 248 patients (59% female, mean age 66.4 years) undergoing TKA in the Bellin Health System during 2022. Trait mindfulness was measured preoperatively using the Mindfulness Attention Awareness Scale (MAAS). Researchers analyzed associations between baseline MAAS scores and outcomes at 12 weeks.

Results: Higher baseline MAAS scores were significantly associated with lower pain interference (β = -1.24, p = .004) and better physical function (β = 0.92, p = .03) at baseline, but not with opioid use. However, MAAS scores did not significantly predict pain, function, or opioid use at 12 weeks postoperatively.

Conclusion: This is the first study exploring trait mindfulness in relation to pain outcomes after TKA. Findings suggest trait mindfulness is related to pain and function at the time of assessment but may not predict longer-term recovery. Additional research into this topic is warranted to determine the value and impact of assessing trait mindfulness in individuals undergoing TKA.

Comparable studies

Other observational and cohort studies on meditation, most cited first.

Study Year Design Participants
Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students 2006 Observational cohort
Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia 1992 Observational cohort n = 22
Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls 2005 Observational cohort n = 20
Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls 2011 Observational cohort
Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls 2004 Observational cohort

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