BACKGROUND: The incidence of revision total hip (rTHA) and knee (rTKA) arthroplasty continues to increase. Preoperative depression is known to influence outcomes following primary arthroplasty. Despite this, it remains unknown whether the same relationship exists for patients undergoing revision procedures. The purpose of this study, therefore, is to investigate this relationship. METHODS: This is a retrospective cohort study. Patients undergoing rTHA and rTKA were identified from the Truven MarketScan database. Patients with a diagnosis of prosthetic joint infection were excluded. Two cohorts were created: those with preoperative depression and those without. We included patients who were enrolled in the database for 1 year preoperatively and postoperatively. Demographic and complication data were collected, and statistical analysis was then performed comparing complications between cohorts. RESULTS: A total of 10,017 patients undergoing rTHA and 13,973 patients undergoing rTKA were included in this study. Of these, 1305 (13.1%) and 2012 (14.4%) had depression, respectively. Multivariate analysis found that, after rTHA, preoperative depression was associated with extended length of stay, nonhome discharge, 90-day readmission, 90-day emergency department visit, prosthetic joint infection, revision surgery, and increased costs (P < .001). Similarly, following rTKA, depression was associated with extended length of stay, nonhome discharge, 90-day readmission, 90-day emergency department visit, revision surgery, and increased costs (P < .001). CONCLUSION: Depression before revision total joint arthroplasty is common and is associated with increased risk of complication and increased healthcare resource utilization following both rTHA and rTKA. Further research will be needed to delineate to what degree this represents a modifiable risk factor.
BACKGROUND: The incidence of revision total hip (rTHA) and knee (rTKA) arthroplasty continues to increase. Preoperative depression is known to influence outcomes following primary arthroplasty. Despite this, it remains unknown whether the same relationship exists for patients undergoing revision procedures. The purpose of this study, therefore, is to investigate this relationship. METHODS: This is a retrospective cohort study. Patients undergoing rTHA and rTKA were identified from the Truven MarketScan database. Patients with a diagnosis of prosthetic joint infection were excluded. Two cohorts were created: those with preoperative depression and those without. We included patients who were enrolled in the database for 1 year preoperatively and postoperatively. Demographic and complication data were collected, and statistical analysis was then performed comparing complications between cohorts. RESULTS: A total of 10,017 patients undergoing rTHA and 13,973 patients undergoing rTKA were included in this study. Of these, 1305 (13.1%) and 2012 (14.4%) had depression, respectively. Multivariate analysis found that, after rTHA, preoperative depression was associated with extended length of stay, nonhome discharge, 90-day readmission, 90-day emergency department visit, prosthetic joint infection, revision surgery, and increased costs (P < .001). Similarly, following rTKA, depression was associated with extended length of stay, nonhome discharge, 90-day readmission, 90-day emergency department visit, revision surgery, and increased costs (P < .001). CONCLUSION: Depression before revision total joint arthroplasty is common and is associated with increased risk of complication and increased healthcare resource utilization following both rTHA and rTKA. Further research will be needed to delineate to what degree this represents a modifiable risk factor.
Authors: Belal A Tarakji; Aaron T Wynkoop; Ajay K Srivastava; Erin G O'Connor; Theresa S Atkinson Journal: J Arthroplasty Date: 2018-03-27 Impact factor: 4.757
Authors: Kevin J Bozic; Edmund Lau; Steven Kurtz; Kevin Ong; Harry Rubash; Thomas P Vail; Daniel J Berry Journal: J Bone Joint Surg Am Date: 2012-05-02 Impact factor: 5.284
Authors: Karina Badura-Brzoza; Piotr Zajac; Alicja Kasperska-Zajac; Zenon Brzoza; Jerzy Matysiakiewicz; Magdalena Piegza; Robert T Hese; Barbara Rogala; Jacek Semenowicz; Bogdan Koczy Journal: Int J Psychiatry Clin Pract Date: 2008 Impact factor: 1.812
Authors: Hilal Maradit Kremers; Dirk R Larson; Cynthia S Crowson; Walter K Kremers; Raynard E Washington; Claudia A Steiner; William A Jiranek; Daniel J Berry Journal: J Bone Joint Surg Am Date: 2015-09-02 Impact factor: 5.284
Authors: Steven M Kurtz; Edmund Lau; Kevin Ong; Ke Zhao; Michael Kelly; Kevin J Bozic Journal: Clin Orthop Relat Res Date: 2009-04-10 Impact factor: 4.176
Authors: Mitchell R Klement; Brian T Nickel; Colin T Penrose; Abiram Bala; Cynthia L Green; Samuel S Wellman; Michael P Bolognesi; Thorsten M Seyler Journal: Knee Date: 2016-06-07 Impact factor: 2.199
Authors: Brandon Lippold; Yash R Tarkunde; Abby L Cheng; Charles P Hannon; Muyibat A Adelani; Ryan P Calfee Journal: Arthroplast Today Date: 2022-03-02
Authors: Matthew S Broggi; Philip O Oladeji; Syed Tahmid; Roberto Hernandez-Irizarry; Jerad Allen Journal: Geriatr Orthop Surg Rehabil Date: 2021-05-25
Authors: Jacob M Wilson; Corey A Jones; Jeffrey Scott Holmes; Kevin X Farley; Roberto C Hernandez-Irizarry; Thomas J Moore; Thomas L Bradbury; George N Guild Journal: Arthroplast Today Date: 2022-03-20
Authors: Ryan J Furdock; Bharadwaj Jilakara; Tyler J Moon; Neelansh Bute; Lee Rhea; Douglas McDonald; Cara A Cipriano Journal: Arthroplast Today Date: 2022-01-18