Summary

This systematic review found that pre-operative mental health disorders, particularly anxiety and depression, are associated with poorer clinical outcomes following total ankle arthroplasty, emphasizing the need for mental health evaluation in pre-operative patient management.

Abstract

Introduction

The purpose of this study was to evaluate the relationship between mental health disorders and outcomes following total ankle arthroplasty (TAA).

Methods

We searched PubMed, Cochrane, and Google Scholar from their inception till April 19, 2022. Studies exploring the association of mental health disorders and readmission risk following TJA were selected. The outcomes were divided into 30-day readmission, 90-day readmission, and readmission after 90 days. We also performed subgroup analyses based on the type of arthroplasty: total hip arthroplasty (THA) and total knee arthroplasty (TKA). A total of 12 studies were selected, of which 11 were included in quantitative analysis. A total of 1,345,893 patients were evaluated, of which 73,953 patients suffered from mental health disorders.

Results

In total, 6 studies (1124 patients) were included. Four studies found that pre-operative mental health disorders were associated with inferior clinical outcomes following TAA. Two studies reported no association between pre-operative mental health disorders. Pre-operative anxiety and depression were identified as significant risk factors for inferior clinical outcomes. Pre-operative mental health disorders were not associated with postoperative complications such as infection.

Discussion And Conclusion

This systematic review demonstrated that pre-operative mental health disorders were associated with inferior clinical outcomes following TAA. The evidence presented highlights the importance of addressing mental health considerations in the pre-operative assessment and management of patients undergoing TAA.