Kurt G Seagrave1,2, Adriane M Lewin2,3, Ian A Harris2,3,4, Helen Badge2,3,5, Justine Naylor2,3,4. 1. 4334The University of Sydney School of Medicine, Sydney, New South Wales, Australia. 2. Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia. 3. South West Sydney Clinical School, 7800University of New South Wales, Sydney, New South Wales, Australia. 4. South Western Sydney Local Health District, Sydney, New South Wales, Australia. 5. 276979Australian Catholic University, North Sydney, New South Wales, Australia.
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.
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 patientanxiety 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.
Authors: Lindsay K Smith; Cesar Garriga; Sarah R Kingsbury; Rafael Pinedo-Villanueva; Antonella Delmestri; Nigel K Arden; Martin Stone; Philip G Conaghan; Andrew Judge Journal: BMJ Open Date: 2022-03-09 Impact factor: 2.692
Authors: Umile Giuseppe Longo; Sergio De Salvatore; Alessandra Greco; Martina Marino; Giulia Santamaria; Ilaria Piergentili; Maria Grazia De Marinis; Vincenzo Denaro Journal: J Clin Med Date: 2022-07-02 Impact factor: 4.964