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Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty: A Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up.
J Arthroplasty. 2017 03; 32(3):767-770.JA

Abstract

BACKGROUND

After more than 4 decades experience of total knee arthroplasty (TKA), there is still a group of patients who are not satisfied with the outcome. In spite of the improvement of many aspects around the procedure, for unexplainable reasons, patient dissatisfaction is still approximately the same. We conducted this study to analyze correlations between preoperative psychological aspects and dissatisfaction after TKA.

METHODS

A total of 186 patients were operated with a primary TKA. Patients filled out the Hospital Anxiety and Depression Scale, Visual Analog Pain Scale (0-100), and Knee injury and Osteoarthritis Outcome Score preoperatively and 4 years postoperatively. Four years postoperatively, the patients also scored their satisfaction degree with the outcome of the surgery.

RESULTS

Of 186 patients, 27 (15%) reported that they were dissatisfied or uncertain with the result of their TKA 4 years postoperatively. Sixteen of those 27 patients had reported anxiety/depression preoperatively compared with 11 of 159 (7%) in the satisfied or very satisfied groups. Patients with preoperative anxiety or depression had more than 6 times higher risk to be dissatisfied compared with patients with no anxiety or depression (P < .001). Patients with deep prosthetic infection had 3 times higher risk to be dissatisfied with the operation outcome (P = .03). Dissatisfied patients had 1-day longer hospital stay compared with the satisfied group (P < .001).

CONCLUSION

Preoperative anxiety and/or depression is an import predictor for dissatisfaction after TKA. Psychological assessment and treatment preoperatively might improve degree of satisfaction.

Authors+Show Affiliations

Department of Orthopedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden.Department of Orthopedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden.Department of Orthopedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden.Department of Orthopedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27692782

Citation

Ali, Abdulemir, et al. "Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty: a Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up." The Journal of Arthroplasty, vol. 32, no. 3, 2017, pp. 767-770.
Ali A, Lindstrand A, Sundberg M, et al. Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty: A Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up. J Arthroplasty. 2017;32(3):767-770.
Ali, A., Lindstrand, A., Sundberg, M., & Flivik, G. (2017). Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty: A Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up. The Journal of Arthroplasty, 32(3), 767-770. https://doi.org/10.1016/j.arth.2016.08.033
Ali A, et al. Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty: a Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up. J Arthroplasty. 2017;32(3):767-770. PubMed PMID: 27692782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty: A Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up. AU - Ali,Abdulemir, AU - Lindstrand,Anders, AU - Sundberg,Martin, AU - Flivik,Gunnar, Y1 - 2016/09/03/ PY - 2016/05/03/received PY - 2016/07/18/revised PY - 2016/08/22/accepted PY - 2016/10/4/pubmed PY - 2017/11/2/medline PY - 2016/10/4/entrez KW - HAD KW - KOOS KW - TKA KW - VAS pain KW - dissatisfaction SP - 767 EP - 770 JF - The Journal of arthroplasty JO - J Arthroplasty VL - 32 IS - 3 N2 - BACKGROUND: After more than 4 decades experience of total knee arthroplasty (TKA), there is still a group of patients who are not satisfied with the outcome. In spite of the improvement of many aspects around the procedure, for unexplainable reasons, patient dissatisfaction is still approximately the same. We conducted this study to analyze correlations between preoperative psychological aspects and dissatisfaction after TKA. METHODS: A total of 186 patients were operated with a primary TKA. Patients filled out the Hospital Anxiety and Depression Scale, Visual Analog Pain Scale (0-100), and Knee injury and Osteoarthritis Outcome Score preoperatively and 4 years postoperatively. Four years postoperatively, the patients also scored their satisfaction degree with the outcome of the surgery. RESULTS: Of 186 patients, 27 (15%) reported that they were dissatisfied or uncertain with the result of their TKA 4 years postoperatively. Sixteen of those 27 patients had reported anxiety/depression preoperatively compared with 11 of 159 (7%) in the satisfied or very satisfied groups. Patients with preoperative anxiety or depression had more than 6 times higher risk to be dissatisfied compared with patients with no anxiety or depression (P < .001). Patients with deep prosthetic infection had 3 times higher risk to be dissatisfied with the operation outcome (P = .03). Dissatisfied patients had 1-day longer hospital stay compared with the satisfied group (P < .001). CONCLUSION: Preoperative anxiety and/or depression is an import predictor for dissatisfaction after TKA. Psychological assessment and treatment preoperatively might improve degree of satisfaction. SN - 1532-8406 UR - https://www.unboundmedicine.com/medline/citation/27692782/Preoperative_Anxiety_and_Depression_Correlate_With_Dissatisfaction_After_Total_Knee_Arthroplasty:_A_Prospective_Longitudinal_Cohort_Study_of_186_Patients_With_4_Year_Follow_Up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-5403(16)30580-0 DB - PRIME DP - Unbound Medicine ER -