Not yet recruitingNAINTERVENTIONAL

IMProving Outcomes With ACT After Knee Surgery

This study is exploring a therapy called Acceptance and Commitment Therapy (ACT) for people having a total knee replacement. We know that feeling down, anxious, or having a lot of pain before surgery can sometimes make recovery harder. ACT is a type of talk therapy that helps people accept difficult thoughts and feelings, and focus on what's important to them. Past studies suggest ACT might help reduce pain and improve how well people move after surgery. This first step of the study will check if offering ACT workshops before knee surgery is practical and helpful for patients and the staff delivering it. If it goes well, a larger study might follow to see if ACT can truly improve recovery for those at higher risk.

At a glance

Status

Not yet recruiting

Phase

Sponsor

Belfast Health and Social Care Trust

Enrolment target

Start

01 Sep 2025

Estimated completion

01 Dec 2026

Total Knee Arthroplasty Knee Osteoarthritis

What is this study about?

When people have a total knee replacement (TKA for short), most of them get on really well. However, we've noticed that some patients might find their recovery a bit harder. This can sometimes be linked to how they are feeling emotionally, for example, if they are experiencing depression, anxiety, or a lot of pain before their operation. Doctors and researchers have been looking into ways to help these patients have a smoother recovery.

This study is investigating a specific type of talking therapy called Acceptance and Commitment Therapy (ACT). ACT is different from some other therapies because it helps people accept difficult thoughts and feelings rather than trying to get rid of them. It also helps them focus on their personal values and take steps that align with those values, even when things are tough. ACT uses a mix of mindfulness — which is about focusing on the present moment — and learning new ways to act and cope. Some earlier research has shown that ACT might help people having surgery to use less pain medication, have less pain afterwards, and move better.

This particular study is a 'feasibility study'. This means the main goal is to find out if it's possible and practical to offer ACT workshops to patients before their knee replacement surgery. They are especially interested in patients who might be at higher risk of a difficult recovery based on how they are feeling emotionally. If patients find the workshops helpful and the staff find them easy to deliver, then a much larger study could be done in the future to see if ACT truly makes a big difference to people's recovery after knee surgery.

Key takeaways

Looks at a therapy called ACT for people having knee replacement surgery.
Aims to help people who might struggle more with recovery emotionally.
ACT teaches coping skills, acceptance, and mindfulness.
This is a 'feasibility' study to see if ACT workshops are practical.
If successful, a larger study may follow to check effectiveness.

Who may be eligible?

This study is for adults aged 18 to 100 who are planning to have a routine, first-time total knee replacement. You need to be able to speak and understand English well enough to fill out questionnaires online.

Crucially, only people who score 10 or higher on a depression questionnaire (called the DASS-21) before their surgery can join. This helps the researchers focus on those who might benefit most from the therapy.

You cannot join if you don't have a mobile phone for text messages or internet access for online forms, if your surgery date changes a lot, or if you can't attend the pre-surgery education class. You also can't join if you're having more complex knee surgery (like a revision or surgery on both knees), have other orthopaedic surgery planned soon, or are already having another type of talking therapy.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 or older and planning your first total knee replacement?
Can you speak and write in English well?
Do you have a mobile phone and internet access for online forms?
Are you NOT currently having other talking therapy?
Is your knee surgery routine, not a revision or on both knees?

Answer every question to see your result.

What does participation involve?

If you join this study, you would first fill out some questionnaires online. Based on these, if you meet the specific emotional criteria (scoring 10 or more on a depression questionnaire), you'd be invited to take part in a pre-operative ACT workshop. This workshop would teach you about Acceptance and Commitment Therapy. You would also receive text messages after the workshop to help remind you about the ACT techniques.

You would continue to fill out online questionnaires at various points, likely before surgery and at different times during your recovery, to help the researchers understand how you are doing. The total duration of your active participation, including workshops and answering questionnaires, would likely span from before your surgery through several months of your recovery, though specific follow-up times aren't detailed.

Potential risks and benefits

Taking part in this study may offer potential benefits, such as learning new coping strategies through Acceptance and Commitment Therapy that could help manage pain, anxiety, and improve your recovery following knee surgery. However, there's no guarantee that you will personally benefit. On the other hand, participating involves committing time to workshops and questionnaires, which might be inconvenient for some. There are no known physical risks associated with this type of talk therapy. You are free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Musgrave Park Hospital
Verified postcode
Belfast, United Kingdom

Common questions

What is a total knee replacement?

It's a surgery where damaged parts of the knee joint are replaced with artificial parts to help reduce pain and improve movement.

What is Acceptance and Commitment Therapy (ACT)?

ACT is a type of talk therapy that helps people accept difficult thoughts and feelings, focus on their personal values, and take positive steps in their life.

Why is this study only for people with higher depression scores?

The researchers want to see if ACT can especially help those who might be at a higher risk of a harder recovery due to feeling down or anxious before surgery.

Will I have to pay to be in the study?

No, you will not have to pay to participate in the study. All study-related treatments and assessments are free.

What happens after this study?

This is a small first step. If it shows ACT is practical and helpful, a larger study might be done later to confirm if it truly improves outcomes for more people.

How to find out more

Nicola Gallagher

nicola.gallagher@belfasttrust.hscni.net 02895043746 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.