The Impact of Depression, Personality, and Mental Health on Outcomes of Total Knee Arthroplasty

Abstract

Despite great advances in total knee arthroplasty (TKA) implants and techniques in recent years, approximately 20% of patients have reported little or no postoperative improvement in pain, physical function, and quality of life (QOL). 1,2) These results could not be explained completely by surgical and physical characteristics. Recent studies have demonstrated that preoperative psychological factors may play a role in postoperative dissatisfaction of patients. 3) Vissers et al. 2) demonstrated that patients with a better preoperative self-reported mental health score were more often satisfied. Giurea et al. 4) showed significant influence of 4 personality traits on patient satisfaction: life satisfaction, performance orientation, somatic distress, and emotional stability. In an investigation about the relationship between patients' diverse personalities and

The Impacts of Anxiety and Depression on Outcomes in Foot and Ankle Surgery

“…Depression and anxiety have been well-studied as factors that negatively predict the degree of surgical success in orthopaedics; however, investigations into the impacts of depression and anxiety in foot and ankle surgery are fewer and more recent than investigations focusing on other anatomical areas. Mental health disorders have been demonstrated to negatively affect surgical outcomes for a wide range of orthopaedic surgeries, including total hip and knee arthroplasties, 2,26,27,30,35,38,40,51,66,74 hip arthroscopy, 23,37,48,63,64 shoulder and elbow surgery, 43,67,71 and spine surgery. 10,47,62 The contributions of depression and anxiety to foot and ankle pain and the success of foot and ankle surgery have been more properly investigated in the past 5 years; however, they have not yet been summarized and critically analyzed in a review of the literature.…”

The Impact of Surgeon Variability on Patient-Reported Outcome Measures, Length of Stay, Discharge Disposition, and 90-Day Readmission in TKA

“…The baseline VR-12 MCS also contributed greatly to the prediction of hospital stay (AIC increase, 20) and 90-day readmission (AIC increase, 5.3), ranking fourth in importance for both outcomes. Previous literature has demonstrated a notable prevalence of mental health dysfunction among candidates for TKA 51 and its effect on postoperative pain and function 46,52 , quality of life 53 , and hospital readmission 54,55 . The findings of the present study further quantify the impact of baseline mental health status on postoperative outcomes and emphasize the need to include preoperative mental health in model-fitting for patient-reported outcome measures after TKA.…”

Presence of Night Pain, Neuropathic Pain, or Depressive Disorder Does Not Adversely Affect Outcomes After Total Knee Arthroplasty: A Prospective Cohort Study

“…A number of papers have suggested that pre- and postoperative functional outcome scores and HRQOL scores are poorer in patients with preoperative depression than in those without depression. 25 27 42 46 47 However, some papers report that the net change in the outcome improvement itself is no different between the groups with and without depression 27 41 48 and that there is no difference in satisfaction. 26 27 43 In addition, some studies have reported that depression is not included as a predictor of persistent postoperative pain or poor outcome.…”