Effect of Psychopathology on Patient-Perceived Outcomes of Total Knee Arthroplasty within an Indigent Population

Abstract

Not only is there a high prevalence of psychopathology in the indigent population, but psychopathology may result in lower patient-perceived outcome scores at one year after a total knee arthroplasty. Even though outcome scores may be worse for patients with psychopathology, our study showed that these patients still benefit, with the same degree of improvement in function.

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

“…The remaining six studies did not examine these states specifically but showed that lower preoperative mental health scores had similar postoperative associations [8,9,13,27,46,47,50]. Pain scores in the patient population with anxiety, depression, or lower mental health scores were elevated at baseline and at all assessment points [13,27,28,34,37,47,50] for up to 2 years in one study [34 ]. Lingard and Riddle [34] estimated the effect to be 3 to 5 points lower on the 20-point pain component of the WOMAC, indicating worse pain in the group of patients with lower mental health scores.…”

“…Of the 19 studies, there were 17 cohort studies [3, 5, 8, 9, 13, 14, 24, 26-28, 34, 37, 39, 44, 46, 47, 50] and two cross-sectional surveys [15,18], including five level 1 prognostic studies [3,8,13,34,39]. The studies were conducted in seven countries: 10 in the USA [3,5,8,9,13,14,24,34,39,46]; four in the UK [27,34,44,50]; four in Canada; [18,26,34,47]; and one each in Australia [34], Spain [15], Greece [37], and Korea [28].…”

“…The studies were conducted in seven countries: 10 in the USA [3,5,8,9,13,14,24,34,39,46]; four in the UK [27,34,44,50]; four in Canada; [18,26,34,47]; and one each in Australia [34], Spain [15], Greece [37], and Korea [28]. Most studies (17) were conducted in metropolitan populations; one study was a multinational cohort study conducted in 13 centers in four countries (UK, USA, Australia, and Canada) [34].…”

“…Most studies (17) were conducted in metropolitan populations; one study was a multinational cohort study conducted in 13 centers in four countries (UK, USA, Australia, and Canada) [34]. One study included a rural and metropolitan population [37] and one included only patients from indigent backgrounds [13]. In total, our review reports on studies including 9046 TKAs performed in 8704 patients, of which 5494 (63%) were women.…”

“…Two studies used the Pain Catastrophizing Scale [39,47]. Other psychological assessment tools included the Self-Efficacy Scale [50], Purpose In Life [46], Patient Health Questionnaire [13], Hospital Anxiety and Depression scale [5], and the Centre for Epidemiological Studies Depression scale [37]. The heterogeneity in the use of psychological tools and outcomes precluded data pooling for the purposes of performing a meta-analysis.…”