Association between pre-operative anxiety and/or depression and outcomes following total hip or knee arthroplasty

Journal article

Seagrave, Kurt G., Lewin, Adriane M., Harris, Ian A., Badge, Helen and Naylor, Justine. (2021). Association between pre-operative anxiety and/or depression and outcomes following total hip or knee arthroplasty. Journal of Orthopaedic Surgery. 29(1), pp. 1-10. https://doi.org/10.1177/2309499021992605
AuthorsSeagrave, Kurt G., Lewin, Adriane M., Harris, Ian A., Badge, Helen and Naylor, Justine
Abstract

Purpose:
While elective primary total hip (THA) and knee (TKA) arthroplasty are effective procedures for addressing the symptoms associated with advanced osteoarthritis, there is evidence to suggest that patient anxiety and depression are linked to poorer outcomes following surgery.

Methods:
A secondary analysis of prospectively-collected data of people undergoing primary elective THA or TKA for osteoarthritis across 19 hospitals was performed. We assessed outcomes at 1 year post-surgery for people with and without medically treated anxiety and/or depression at the time of surgery (A/D and no-A/D). We used unadjusted and adjusted analyses to compare improvement in Oxford Hip or Knee Scores, the incidences of major post-operative complications, satisfaction and index joint improvement by A/D status.

Results:
15.2% (254/1669) of patients were identified with anxiety and/or depression at time of surgery. In the unadjusted analysis, the A/D group had greater mean Oxford score improvement by 2.1 points (95% CI 0.8 to 3.4, p = 0.001), increased major complications (OR 1.39, 95% CI 1.05 to 1.85, p = 0.02), were less likely to report a “much better” global improvement for index joint (OR 0.56, 95% CI 0.38 to 0.83, p = 0.003), and there was no statistically significant difference in the rate of satisfaction with the results of surgery (OR 0.64, 95% CI 0.37 to 1.10, p = 0.10). The adjusted analysis found no significant associations between A/D vs. no-A/D and any of the reported outcomes.

Conclusion:
After adjustment for confounding variables, people with anxiety and/or depression pre-operatively, compared to those without, have similar outcomes following hip or knee arthroplasty.

Keywordsanxiety; arthroplasty; depression; orthopedics; outcomes
Year2021
JournalJournal of Orthopaedic Surgery
Journal citation29 (1), pp. 1-10
PublisherHong Kong Academy of Medicine Press
ISSN1022-5536
Digital Object Identifier (DOI)https://doi.org/10.1177/2309499021992605
Scopus EID2-s2.0-85101259107
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range1-10
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online18 Feb 2021
Publication process dates
Accepted18 Jan 2021
Deposited09 Nov 2021
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