Yoshinori Hiyama1, Tsukasa Kamitani2, Osamu Wada3. 1. Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan. Electronic address: hiyamayn@stf.teu.ac.jp. 2. Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan. 3. Anshin Hospital, Hyogo, Japan.
Abstract
BACKGROUND: Patients who undergo total knee arthroplasty (TKA) may experience disease-specific problems, including decline in motor function and intense pain, which may result in disease-specific anxiety. This study aimed to investigate disease-specific anxiety at discharge, and any association between anxiety and functional outcomes following TKA. METHODS: The study prospectively included 129 patients who had undergone TKA. Each patient's disease-specific anxiety about wounds, pain, gait, and falling was assessed at discharge using a numerical rating scale, in which 0 represented no anxiety and 10 represented the highest level of anxiety. In addition, patient-reported outcomes (PROs) were evaluated using the Knee Society Score (KSS) at six-months postoperatively. The effects of disease-specific anxiety at discharge were evaluated with the KSS at six-months postoperatively and analyzed separately using multiple regression analysis. RESULTS: The median score for anxiety about wounds, pain, and gait was 4.0 (IQR 2.0-5.0) at discharge five days after surgery. The median score for anxiety about falling was also 4.0 (IQR 2.0-6.0). The level of anxiety regarding wounds, pain, gait, and falling was negatively associated with the KSS six-months postoperatively after adjusting for all confounding factors (wounds: β = -2.8, 95% CI -4.3 to -1.3; pain: β = -3.4, 95% CI -4.9 to -1.9; gait: β = -4.3, 95% CI -5.8 to -2.9; falling: β = -2.5, 95% CI -3.9 to -1.1). CONCLUSION: Patients reported similar levels of anxiety regarding wounds, pain, gait, and falling at discharge after TKA. The severity of anxiety symptoms at discharge was negatively associated with PROs six-months postoperatively.
BACKGROUND:Patients who undergo total knee arthroplasty (TKA) may experience disease-specific problems, including decline in motor function and intense pain, which may result in disease-specific anxiety. This study aimed to investigate disease-specific anxiety at discharge, and any association between anxiety and functional outcomes following TKA. METHODS: The study prospectively included 129 patients who had undergone TKA. Each patient's disease-specific anxiety about wounds, pain, gait, and falling was assessed at discharge using a numerical rating scale, in which 0 represented no anxiety and 10 represented the highest level of anxiety. In addition, patient-reported outcomes (PROs) were evaluated using the Knee Society Score (KSS) at six-months postoperatively. The effects of disease-specific anxiety at discharge were evaluated with the KSS at six-months postoperatively and analyzed separately using multiple regression analysis. RESULTS: The median score for anxiety about wounds, pain, and gait was 4.0 (IQR 2.0-5.0) at discharge five days after surgery. The median score for anxiety about falling was also 4.0 (IQR 2.0-6.0). The level of anxiety regarding wounds, pain, gait, and falling was negatively associated with the KSS six-months postoperatively after adjusting for all confounding factors (wounds: β = -2.8, 95% CI -4.3 to -1.3; pain: β = -3.4, 95% CI -4.9 to -1.9; gait: β = -4.3, 95% CI -5.8 to -2.9; falling: β = -2.5, 95% CI -3.9 to -1.1). CONCLUSION:Patients reported similar levels of anxiety regarding wounds, pain, gait, and falling at discharge after TKA. The severity of anxiety symptoms at discharge was negatively associated with PROs six-months postoperatively.