Influence of Depressive Symptoms on Hallux Valgus Surgical Outcomes

Shakked, Rachel; McDonald, Elizabeth; Sutton, Ryan; Lynch, Mary-Katherine; Nicholson, Kristen; Raikin, Steven M.

doi:10.1177/1071100718762137

Cited by 27 publications

(38 citation statements)

References 20 publications

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“…Despite higher HV deformity degree has been previously associated with psychological disorders [4,5,47], this study might be considered as the first cross-sectional study detailing greater kinesiophobia symptoms, total scores as activity avoidance and harm domains scores, as well as pain intensity associated with higher HV degree deformity, especially for severe and/or moderate HV deformity degrees with respect to non-presence of HV and/or mild HV deformity degrees. Indeed, moderate kinesiophobia level deformity showed a clear increase according to greater HV deformity degrees.…”

Section: Discussionmentioning

confidence: 90%

“…Future studies should propose interventions in order to reduce kinesiophobia and pain intensity in patients with HV, such as myofascial pain interventions [53,54], neural mobilization techniques [55], or surgical procedures [47]. In addition, other outcome measurements should be evaluated in order to determine the influence of HV mechanical soft tissue properties on pain and kinesiophobia, such as myofascial trigger points evaluation [56], sonoelastography [57], pressure pain threshold [58], or thermography [59].…”

Section: Future Studiesmentioning

confidence: 99%

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Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

Palomo‐López

Becerro-de-Bengoa-Vallejo

Iglesias

et al. 2020

IJERPH

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Background: Hallux valgus (HV) has been previously associated with psychological disorders. Thus, the purposes of this study were to associate kinesiophobia and pain intensity with HV deformity degrees, as well as predict kinesiophobia and pain intensity based on HV deformity and demographic features. Methods: A cross-sectional study was carried out recruiting 100 subjects, who were divided into HV deformity degrees, such as I-no HV (n = 25), II-mild (n = 25), III-moderate (n = 25), and IV-severe (n = 25) HV. Kinesiophobia total and domains (activity avoidance and harm) scores and levels were self-reported by the Tampa Scale of Kinesiophobia (TSK-11). Pain intensity was self-reported by the numeric rating scale (NRS). Results: Statistically significant differences (p < 0.01; η2 = 0.132–0.850) were shown for between-groups comparison of kinesiophobia total and domain scores (activity avoidance and harm) and levels, as well as pain intensity among HV deformity degrees. Post hoc comparisons showed statistically significant differences with a large effect size (p < 0.05; d = 0.85–4.41), showing higher kinesiophobia symptoms and levels and pain intensity associated with greater HV deformity degrees, especially for III-moderate and/or IV-severe HV deformity degrees versus I-no HV and/or II-mild deformity degrees. Both statistically significant prediction models (p < 0.05) for kinesiophobia (R2 = 0.300) and pain intensity (R2 = 0.815) were predicted by greater HV deformity degree and age. Conclusions: Greater kinesiophobia symptoms and levels and pain were associated with higher HV deformity degrees, especially severe and/or moderate HV with respect to no and/or mild HV. The kinesiophobia and pain intensity were predicted by greater HV deformity degree and age.

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Section: Discussionmentioning

confidence: 90%

Section: Future Studiesmentioning

confidence: 99%

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

Palomo‐López

Becerro-de-Bengoa-Vallejo

Iglesias

et al. 2020

IJERPH

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“…23 Because operative correction of hammertoes is pursued when nonoperative measures fail to treat patients’ subjective pain and people with depression are more likely to report bothersome foot and ankle–related symptoms, one explanation for this discrepancy in prevalence may be that patients taking psychotropic medications seek operative management of symptomatic hammertoe more readily. 7,27…”

Section: Discussionmentioning

confidence: 99%

Effect of Psychotropic Medications on Hammertoe Reconstruction Outcomes

Maidman

Erwood

Fantry

et al. 2020

Foot & Ankle Orthopaedics

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Background: Hammertoe deformities can seriously affect activity level and footwear. The use of prescription, mood-altering medications is very common, with some estimates as high as 25% of the population. Mood disorders, especially depression, negatively affect the results of medical and operative treatments. This study assessed the relationship of mood-altering medication use with the outcomes and complications of operative reconstruction of hammertoes. Methods: Data were prospectively collected from 116 patients who underwent hammertoe reconstruction, including demographic information, medical history, the use of mood-altering psychotropic medications (antidepressants, anxiolytics, hypnotics, and mood stabilizers), and postoperative complications. Preoperative patient-reported outcomes were measured using the visual analog scale (VAS) for pain and Short Form Health Survey (SF-36), which were repeated at 1-year follow-up. Results: A total of 36.2% of patients were taking psychotropic medications. Medication and nonmedication groups had similar pain VAS and SF-36 Physical Component Summary (PCS) scores before and after surgery. Compared with nonmedication patients, patients on psychotropic medications had significantly lower SF-36 Mental Component Summary (MCS) scores preoperatively ( P = .001) and postoperatively ( P = .006), but no significant difference in the change in MCS (ΔMCS) from preoperative to postoperative. Psychotropic medication use was associated with superficial wound infections ( P = .048), but not other complications. Conclusions: Patients taking psychotropic medications were equally likely to benefit from forefoot reconstruction as nonmedication patients. Preoperative and postoperative PCS and VAS were not significantly different between medication and nonmedication groups. Although the medication group had lower absolute MCS, they reported the same magnitude of improvement in MCS (ΔMCS) as the nonmedication group. Level of Evidence: Level II, prospective cohort study.

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“…Depression as identified using the SF-12 MCS was also found to affect 2-year outcomes in patients who underwent surgical hallux valgus correction. 36 In clinical practice, if patients are identified as potentially having depression, patient education regarding the importance of their psychological health to postoperative outcomes should be considered. Referral to a mental health care provider to evaluate and provide intervention may also be indicated.…”

Section: Discussionmentioning

confidence: 99%

“…The SF-12 MCS has been found to be a valid measure of mental health, with evidence to support its ability in screening for symptoms of depression (specificity: 0.87; sensitivity: 0.83). 10,20,40 Previous studies determined the cutoff score using the SF-12 MCS to identify those with symptoms of depression as <46.5 21,36,40 and those with a more severe disorder as ≤36. 10 The iHOT-12 is an outcome instrument developed for hip arthroscopic surgery, with psychometric evidence to support its use.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Depression on Patient Outcomes in Hip Arthroscopic Surgery

Martin

Christoforetti

McGovern

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Mental health impairments have been shown to negatively affect preoperative self-reported function in patients with various musculoskeletal disorders, including those with femoroacetabular impingement.Hypothesis:Those with symptoms of depression will have lower self-reported function, more pain, and less satisfaction on initial assessment and at 2-year follow-up than those without symptoms of depression.Study Design:Cohort study; Level of evidence, 3.Methods:Patients who were enrolled in a multicenter hip arthroscopic surgery registry and had 2-year outcome data available were included in the study. Patients completed the 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and 12-item Short-Form Health Survey (SF-12) when consenting for surgery. At 2-year follow-up, patients were emailed the iHOT, the VAS, and a rating scale of surgical satisfaction. Initial SF-12 mental component summary (MCS) scores <46.5 and ≤36 were used to qualify symptoms of depression and severe depression, respectively, as previously described and validated. Repeated-measures analysis of variance was performed to compare preoperative and 2-year postoperative iHOT-12, VAS, and satisfaction scores between those with and without symptoms of depression.Results:A total of 781 patients achieved the approximate 2-year milestone (mean follow-up, 735 ± 68 days), with 651 (83%) having 2-year outcome data available. There were 434 (67%) female and 217 (33%) male patients, with a mean age of 35.8 ± 13.0 years and a mean body mass index of 25.4 ± 8.8 kg/m2. The most common procedures were femoroplasty (83%), followed by synovectomy (80%), labral repair (76%), acetabuloplasty (58%), acetabular chondroplasty (56%), femoral chondroplasty (23%), and labral reconstruction (19%). The mean initial SF-12 MCS score was 51.5 ± 10.3, with cutoff scores indicating symptoms of depression and severe depression in 181 (28%) and 71 (11%) patients, respectively. Patients with symptoms of depression scored significantly (P < .05) lower on the initial iHOT-12 and VAS and 2-year follow-up iHOT-12, VAS, and rating scale of surgical satisfaction.Conclusion:A large number of patients who underwent hip arthroscopic surgery presented with symptoms of depression, which negatively affected self-reported function, pain levels, and satisfaction on initial assessment and at 2-year follow-up. Surgeons who perform hip arthroscopic surgery may need to identify the symptoms of depression and be aware of the impact that depression can have on surgical outcomes.

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Influence of Depressive Symptoms on Hallux Valgus Surgical Outcomes

Abstract: Level III, comparative study.

Cited by 27 publications

References 20 publications

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

Effect of Psychotropic Medications on Hammertoe Reconstruction Outcomes

The Impact of Depression on Patient Outcomes in Hip Arthroscopic Surgery

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