Inclusion Criteria:
- Patients are deemed eligible at 3 months post-operatively if: The patient completed a primary knee replacement \[surgery completed without complication and patient exhibits full mechanical joint function, as determined by the treating physician (good range of motion, stability, and wound healing; absence of swelling)\] and patient reports last week average knee pain ≥ 4 of 20 and at least two questions rated 'moderate' on A 12-item shortened version (ShortMAC) of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
- Reported pre-operative chronic knee pain of at least 6 months duration prior to surgery
- The procedure was a primary (not a revision) knee replacement
- Proficient in English
Exclusion Criteria:
- Patients who are not willing to participate in a telehealth visit.
- Patients with pre-op chronic pain but who do not have post-operative pain after the three month time period.
- Active suicidal ideation with intent, recent history of suicide attempt, or self-harm behaviors within the past 5 years (including non-suicidal self-harm).
- Recent history of inpatient psychiatric hospitalization within the past 5 years.
- Active, current psychosis or mania.
- Active, current substance abuse, or problems with substance abuse within the past 2 years.
- Instability in living conditions or major interfering life events:
- Major surgery or other major medical event planned in coming 6 months.
- Uncertain whether they will have suitable conditions for telehealth appointments over the next 2 months, including access to a computer or tablet, reliable high-speed internet, and a quiet, comfortable room that is consistently available.
- Major, interfering changes in employment or housing anticipated over the next 6 months.
- Neurological conditions (e.g., Alzheimer's, dementia, mild cognitive impairment, Huntington's disease, multiple sclerosis, cerebral palsy). This will be case-by-case decision made by PI to determine if the condition may interfere with treatment and warrant exclusion.
- Self-reported diagnosis of an autoimmune disease (e.g., rheumatoid arthritis, polymyalgia rheumatica, scleroderma, lupus, polymyositis, or another autoimmune disorder).
- Currently or plan to be involved in lawsuits related to pain in next 6 months, currently or plan to apply for any disability payments related to the pain in next 6 months, or received legal settlement or other disability payments related to the pain over past 2 years.
EEG Exclusion Criteria (patients can still be enrolled as long as they meet all other eligibility criteria; however, they will not undergo EEG testing):
- Are unable or uncomfortable with completing a dry cap EEG.
- Has had a history of abnormal EEGs.
- Had bilateral TKA