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Updated: Apr 19, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Trauma history as a resilience factor for patients recovering from total knee replacement surgery
Julie K Cremeans-Smith1, Kenneth Greene, Douglas L Delahanty
1a Department of Psychology , Kent State University at Stark , N Canton , OH , USA.
Unlabelled:
Research concerning the impact of trauma history on individuals' ability to cope with subsequent events is mixed. While many studies find that trauma history increases vulnerability for conditions such as post-traumatic stress disorder and chronic pain, others reveal that there are benefits associated with moderate levels of stress (e.g. development of coping skills).
Objective:
The present study investigated whether the experience of prior traumatic stressors would serve as a risk or resilience factor based on physical and emotional outcomes among patients recovering from total knee replacement surgery (TKR).
Design:
110 patients undergoing unilateral, TKR completed surveys before surgery, as well as one and three months following the procedure.
Results:
Contrary to hypotheses, patients who reported more prior traumas experienced less severe pain and functional limitations at one- (β = -.259, p = .006) and three-month follow-up assessments (β = -.187, p = .04). A similar pattern emerged when specific types of traumas (e.g. interpersonal) were examined in relation to physical recovery. Further, patients' trauma history was negatively related to symptoms of post-traumatic stress three-months following surgery (e.g. Avoidance: β = -.200, p = .037).
Conclusion:
Trauma history represents a source of resilience, rather than vulnerability, within the context of arthroplastic surgery.
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