Psychological factors as risk factors for poor hip function after total hip arthroplasty

Abstract

Recovery after total hip arthroplasty (THA) is influenced by several psychological aspects, such as depression, anxiety, resilience, and personality traits. We hypothesized that preoperative depression impedes early functional outcome after THA (primary outcome measure). Additional objectives were perioperative changes in the psychological status and their influence on perioperative outcome. This observational study analyzed depression, anxiety, resilience, and personality traits in 50 patients after primary unilateral THA. Hip functionality was measured by means of the Harris Hip Score. Depression, state anxiety, and resilience were evaluated preoperatively as well as 1 and 5 weeks postoperatively. Trait anxiety and personality traits were measured once preoperatively. Patients with low depression and anxiety levels had significantly better outcomes with respect to early hip functionality. Resilience and personality traits did not relate to hip functionality. Depression and state anxiety levels significantly decreased within the 5-week stay in the acute and rehabilitation clinic, whereas resilience remained at the same level. Our study suggests that low depression and anxiety levels are positively related to early functionality after THA. Therefore, perioperative measurements of these factors seem to be useful to provide the best support for patients with risk factors.

Investigating the True Effect of Psychological Variables Measured Prior to Arthroplastic Surgery on Postsurgical Outcomes: A P-Curve Analysis

“…Following this initial review, 46 full-texts were assessed for eligibility of which 20 manuscripts were excluded for at least one of the following reasons: non-significant findings (n = 6) 1,10,48,56,58,63 , the analyses/results were not relevant to review hypotheses (n = 6) 6,9,20,35,42,90 , and the critical test statistic was not reported, could not be computed based on reported data, and could not be obtained after contact with the author (n = 3) 3,18,86 (see Figure 1). The latter criterion included studies reporting pvalue ranges (e.g.…”

“…Patients' pre-surgical psychological profiles may play a major role in determining the long-term efficacy of surgery by affecting the recovery process 13,32,40,45,59,60,68,[78][79][80] . Specifically, preoperative levels of fear of pain 41,79 , pain catastrophizing 22,80,87 , depression 11,20,63,64,68 , optimism 55 , self-efficacy 18,86,88 , kinesiophobia 20 , and anxiety 6,20 have been suggested to explain some of the variability in outcomes, such as pain intensity and function, following arthroplasty and may represent promising avenues for future interventions. Nevertheless, there is considerable heterogeneity in these findings, which has cast doubt onto the presence of true effects 40,87 .…”

Preoperative psychosocial factors predicting patient’s functional recovery after total knee or total hip arthroplasty: a systematic review

“…Contacting authors for unavailable full texts (n = 2) resulted in one additional included study. Of the 26 studies, 17 studies included patients awaiting total knee arthropla sty, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] 7 studies included patients awaiting total hip arthroplasty [36][37][38][39][40][41][42] and 2 studies included patients awaiting either total knee or total hip arthroplasty. 43,44 In total, 11,020 patients were included.…”

“…37,[43][44][45] All nine studies on total hip arthroplasty evaluated the perceived functional recovery. [36][37][38][39][40][41][42][43][44] The three most commonly studied psychosocial categories were personality traits, 42,44 mental wellbeing [38][39][40]42,43,45 and social support. 41…”

Effect of preoperative psychological interventions on elective orthopaedic surgery outcomes: a systematic review and meta‐analysis

“…This result is significant, considering that the TKA population is at greater risk than the general population of psychological impairment . This relationship has also been demonstrated in THA; Benditz et al . found that low depression and anxiety scores are positively related to early functionality.…”