Early Postoperative Psychological Resilience Patterns and Associated Factors in Patients with Knee Stiffness...

Knee stiffness substantially impairs mobility and quality of life. Although arthroscopic release can improve joint function, little is known about early postoperative changes in psychological resilience among these patients.

This study aimed to identify heterogeneous early postoperative psychological resilience patterns in patients with knee stiffness undergoing arthroscopic release surgery and to explore factors associated with pattern membership.

A prospective observational study was conducted among patients undergoing arthroscopic release for knee stiffness. Psychological resilience was assessed using the Connor-Davidson Resilience Scale at four time points: admission before surgery, 3 days after surgery, 2 weeks after surgery, and 1 month after surgery. Latent class growth modeling was used to identify early postoperative resilience pattern groups. Univariate analyses and multinomial logistic regression were conducted to explore factors associated with pattern membership. Multicollinearity among candidate predictors was assessed before multivariable modeling.

A total of 240 patients completed all four assessments. The LCGM identified three early postoperative psychological resilience pattern groups: the Low Resilience Declining Group (17.1%), the Moderate Resilience Stable Group (68.8%), and the High Resilience Increasing Group (14.2%). Multinomial logistic regression using standardized continuous psychosocial predictors showed that, compared with the High Resilience Increasing Group, patients in the Low Resilience Declining Group had lower perceived social support and poorer sleep quality. Compared with the High Resilience Increasing Group, patients in the Moderate Resilience Stable Group were more likely to have a primary-school education or below, lower perceived social support, and lower ERRI scores.

Psychological resilience showed heterogeneous patterns during the early postoperative period after arthroscopic release for knee stiffness. The findings may help identify patients who are psychologically vulnerable during early recovery, but should be interpreted as exploratory because of the single-center design, short follow-up duration, and limited subgroup sizes. Further multicenter studies with longer follow-up and orthopedic outcome measures are needed to validate these early postoperative patterns and clarify their clinical significance.

The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01903-1.