Preoperative mental health status does not effect outcomes in patients after osteochondral allograft transplantation.
Patient-reported outcome measures (PROMs) are progressively utilized as evaluation tools in pre- and postoperative assessments in orthopedic practice. Identifying the potential utility of psychosocial factors to predict patient-reported pain and functional outcomes is of increasing interest to determine which patients will derive the greatest benefit from surgical treatment. Hence, the purpose of this study was to determine potential predictive associations between the preoperative mental component of the Short Form-12 (SF-12 MCS), patient characteristics or osteochondral allograft (OCA) morphology, and PROMs in patients that underwent OCA transplantation. We hypothesized that poor preoperative mental health is associated with diminished PROMs at final follow up.
Sixty-seven patients with an average follow-up of 2.7 (SD, 1.0; range, 2 - 6) years were included in this study with complete preoperative and at least 24 months postoperative SF-12 MCS, KOOS, Tegner, Lysholm and International Knee Documentation Committee Form (IKDC). Pearson’s correlation and linear regression models were used to distinguish associations between age, sex, smoker status, BMI, Worker’s Compensation, previous surgeries, concomitant surgeries, number of grafts, defect location, total graft size, SF-12 MCS and postoperative PROMs as well as their improvement (Delta) from baseline.
The SF-12 MCS showed significant correlation with KOOS Activities of Daily Life (ADL), KOOS Sport/Recreation and IKDC (p = 0.015; p = 0.024; p = 0.039). In the multivariable linear regression models, the SF-12 MCS had no predictive association with any PROM. Patient’s sex contributed significantly to the final regression models of KOOS Sport/Recreation, Tegner and Lysholm (p = 0.042; p = 0.024; p = 0.031). The SF-12 MCS showed no bivariate correlation with any PROM Delta (p > 0.05).
Preoperative mental health status did not predict perceived functional outcomes as measured by PROMs at final follow-up. Female sex was negatively correlated with KOOS Sport/Recreation, Tegner and Lysholm.