Background The Common Sense Model (CSM) identifies cognitive and emotional representations that influence the recovery process. In contrast to previous studies that related individual representations to outcome variables, we used cognitive schemata for prediction of the recovery process after a total hip replacement (THR). Method The purpose of this prospective study is to examine the importance of these schemata for functionality three and six months after THR. One additional predictive model was tested: emotional representation was extended to include depression and anxiety. 317 patients with primary THR were interviewed at t0. Preoperatively, the illness perception was assessed by the Illness Perception Questionnaire-Revised, and the function by the Western Ontario and McMaster Universities arthrosis index (WOMAC). 292 patients participated at all time points. A two-stage cluster analysis revealed two schemata. With generalized linear models-analyses, regressions were calculated. Results THR led to an increase in functionality in both schemata after three and six months. Before THR two cognitive schemata are found: scheme one: medium identity, long duration, many consequences, low personal and treatment control, and low coherence; scheme two: low identity, short timeline, low consequences, and high personal and treatment control. Patients with scheme 2 had better functionality three months after surgery than those with scheme one. Only the addition of depression leads to a slight improvement in prediction. Conclusions Surgery outcome could be improved substantially if the illness representation of patients with schema one and depression could be changed by an intervention preoperatively.

This project is open access and publicly accessible.