Relationships Between Preoperative Mental Health and Improvements in Patient-Reported Outcomes After Total Hip and Knee Arthroplasty

Ren, Renee; Lim, Tiffany Y.; Stern, Brocha Z.; Huang, Hsin-Hui; Poeran, Jashvant; Hayden, Brett L.; Chen, Darwin; Moucha, Calin S.

doi:10.1016/j.arth.2022.10.043

Cited by 4 publications

(4 citation statements)

References 51 publications

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“…In contrast to physical HRQoL, mental HRQoL at one month and twelve months after THA was influenced exclusively by psychological distress at baseline, measured by the PHQ-4. Our results confirm recent studies that have demonstrated that psychological distress influences the clinical outcome after arthroplasty [ 37 – 41 ]. These findings not only suggest that mental health should be routinely assessed prior to arthroplasty but also that preventive measures should be considered in patients with signs of anxiety and depression to improve the outcome of THA.…”

Section: Discussionsupporting

confidence: 92%

Influence of health literacy on health-related quality of life after total hip arthroplasty

Strahl,

Bücker,

Bechler

et al. 2023

Arch Orthop Trauma Surg

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Introduction Personal knowledge about the own disease, a key component of health literacy (HL), may have a considerable impact on treatment outcomes. The purpose of this study was to investigate whether the patients’ knowledge about the surgical procedure, risks, and aftercare, as well as the satisfaction with the preoperative level of information, has an influence on the health-related quality of life (HRQoL) after primary total hip arthroplasty (THA). Materials and methods A total of 176 patients (68.3 ± 10.3 years, 60.8% female) were evaluated. HRQoL was assessed prior to surgery as well as one and twelve months after THA using the 12-item Short Form Questionnaire. Following standardized surgical informed consent, HL was assessed preoperatively using a self-constructed quiz score, while information satisfaction was measured with a single-item rating scale. Sociodemographic and clinical characteristics, including pain (VAS), functionality (WOMAC), and psychological distress (PHQ-4), were also assessed at baseline. Multiple linear regression analyses were performed to examine whether HL, satisfaction with information, age, social class, WOMAC, VAS, and PHQ-4 predict HRQoL at one and twelve months post-surgery. Results The average HL quiz score was 23 ± 5.1 out of a possible 33 points. Social class index significantly influenced HL (p < 0.001). A weak correlation between HL and age (r = 0.23, p = 0.01) and no correlation between HL and psychological distress (p = 0.868) were observed. One month after THA, physical HRQoL was significantly predicted by the WOMAC index (p = 0.031) and subjective satisfaction with information (p = 0.022), but not by HL. After twelve months, only the WOMAC was a significant predictor (p < 0.001) of physical HRQoL. Conclusion Although subjective satisfaction with the patient’s preoperative level of information had a significant effect on the physical HRQoL at one month after THA, the influence of osteoarthritis severity outweighed this effect after twelve months. HL had no direct influence on HRQoL. These results suggest that patient satisfaction, rather than knowledge, predicts HRQoL.

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Section: Discussionsupporting

confidence: 92%

Influence of health literacy on health-related quality of life after total hip arthroplasty

Strahl,

Bücker,

Bechler

et al. 2023

Arch Orthop Trauma Surg

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“…Webster et al showed that the 12‐item short form health survey (SF‐12) was an adequate alternative to the SF‐36 for use in patients with knee OA who undergo knee replacement [27]. Published studies have reported that a mean SF‐12 physical component score (PCS) and MCS of 50 represents the mean in the general population with a standard deviation of 10 [20, 21]. Patients with MCS of less than 50 points were operationally defined as LMH scores and patients with scores of 50 points or greater were defined as normal mental health (NMH) scores.…”

Section: Methodsmentioning

confidence: 99%

“…Poor mental health is associated with decreased activities, including exercise and sports, social isolation, impaired executive function, accelerated cognitive decline, substance abuse, poor sleep quality and a weakened immune system [13]. Recent studies have shown that mental health improves following knee arthroplasty [1,4,6,20,25]. Goh found patients with low mental health (LMH) preoperatively had greater improvement in mental health and knee function but were more likely to be dissatisfied with early outcomes following unicompartmental knee arthroplasty (UKA) [6].…”

Section: Introductionmentioning

confidence: 99%

Unicompartmental knee arthroplasty improves mental health in patients with single compartment knee osteoarthritis

Plancher,

Briggs,

Commaroto

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study was to determine if preoperative mental health status improves following unicompartmental knee arthroplasty (UKA) in patients with single compartment knee osteoarthritis (OA).MethodsA total of 163 patients underwent UKA [115 (71%) medial, 48 (29%) lateral] (mean age = 65 ± 11) completed preoperative and minimum 2‐year postoperative veterans RAND 12 item health survey (VR‐12) mental component score (MCS). VR‐12 MCS was the primary outcome measure. Secondary measures included VR‐12 physical component summary score (PCS), knee osteoarthritis outcome score (KOOS) and KOOS patient acceptable symptom state at the final follow‐up.ResultsThe median VR‐12 MCS improved from 50.5 [interquartile range (IQR): 43.7−56.8] to 55.0 [IQR: 52.3−57.0] (p < 0.001) at a mean follow‐up of 9.5 ± 4 years (range 2−19 years) following UKA. Preoperative VR‐12 MCS was significantly correlated with patients postoperative VR‐12 PCS (ρ = 0.294, p < 0.01), KOOS pain (ρ = 0.201, p = 0.012), KOOS ADL (ρ = 0.243, p = 0.002) and KOOS quality of life (ρ = 0.233, p < 0.01). Sixty‐three (39%) patients improved from low VR‐12 MCS (<50) to normal VR‐12 MCS (≥50). One hundred forty‐two (87%) achieved a normal VR‐12 MCS score (≥50) postoperatively.ConclusionAt a mean of 10‐year follow‐up, patients who underwent UKA for single compartment osteoarthritic knee pain demonstrated significant improvement in mental health scores. UKA resulted in normal mental health in a majority of patients (87%). The resultant improved mental health scores were associated with improved patient pain and activities of daily living.Level of EvidenceLevel III retrospective cohort study.

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“…The article demonstrates that our patients want their mental health issues to be addressed [4]. In recent years, there has been a growing body of evidence showcasing not only the high prevalence of mental health disorders in those undergoing orthopaedic procedures but also how frequently those individuals are disappointed with their results of treatment, whether because of persistent pain or functional limitations [1,2,5,[7][8][9]. As a result, institutions and funding bodies have demonstrated a newfound interest in further understanding this relationship [6].…”

mentioning

confidence: 99%

Letter to the Editor: What Are Orthopaedic Patients’ and Clinical Team Members’ Perspectives Regarding Whether and How to Address Mental Health in the Orthopaedic Care Setting? A Qualitative Investigation of Patients With Neck or Back Pain

2023

Clin Orthop Relat Res

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Relationships Between Preoperative Mental Health and Improvements in Patient-Reported Outcomes After Total Hip and Knee Arthroplasty

Cited by 4 publications

References 51 publications

Influence of health literacy on health-related quality of life after total hip arthroplasty

Influence of health literacy on health-related quality of life after total hip arthroplasty

Unicompartmental knee arthroplasty improves mental health in patients with single compartment knee osteoarthritis

Letter to the Editor: What Are Orthopaedic Patients’ and Clinical Team Members’ Perspectives Regarding Whether and How to Address Mental Health in the Orthopaedic Care Setting? A Qualitative Investigation of Patients With Neck or Back Pain

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