2025 ISAKOS Biennial Congress ePoster
Anxiety And Depression Prior To Total Knee Arthroplasty Are Associated With Worse Pain And Subjective Function: A Prospective Comparative Study
Margot B. Aalders, MD, Amsterdam, Nederland NETHERLANDS
Jelle P. van der List, MD, PhD, Amsterdam NETHERLANDS
Dirk Jan Hofsteee, Heerhugowaard NETHERLANDS
Lucien C.M. Keijser, MD PhD, Alkmaar, Noord Holland NETHERLANDS
Joyce L. Benner, PhD, Alkmaar, Noord Holland NETHERLANDS
Hendrik Aernout Zuiderbaan, MD PhD, Velsen NETHERLANDS
NorthWest Clinics, Alkmaar, Noord Holland, NETHERLANDS
FDA Status Not Applicable
Summary
Preoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2‐year follow‐up in patients undergoing TKA.
ePosters will be available shortly before Congress
Abstract
Purpose
The aim of this study was to investigate the influence of preoperative anxiety and depression on subjective function, pain and revision rates following total knee arthroplasty (TKA).
Methods
A prospective comparative study was conducted, including 349 patients undergoing TKA surgery between January 2019 and April 2021. Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively, and a set of Patient‐Reported Outcome Measures (PROMs) preoperatively and at 6, 12 and 24 months postoperatively. Patients were categorized into anxiety and depression groups based on HADS scores. PROMs included the Knee injury and Osteoarthritis Outcome Score‐Physical Function Shortform (KOOS‐PS), Oxford Knee Score (OKS) and NRS‐Pain. Differences in PROM scores between the anxiety/depression group and, respectively, non-anxiety/non-depression group were assessed, as well as differences in minimal clinical important difference (MCID) and attainment of Patient Acceptable Symptom State (PASS). Lastly, revision rates were compared.
Results
Anxiety and depression groups exhibited inferior subjective function preoperatively and postoperatively compared to non-anxiety and non-depression groups (all p < 0.05), experienced more pain preoperatively (p < 0.001) and also postoperatively for depression patients (all p < 0.05). Significantly fewer patients with anxiety and depression reached the PASS for KOOS‐PS, OKS and NRS‐Pain (all p < 0.05). There were no differences in the proportion of patients reaching the MCID for all PROMs (all p > 0.060), and revision rates did not differ between groups (both p > 0.96).
Conclusion
Preoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2‐year follow‐up in patients undergoing TKA. Revision rates did not differ between groups, and there were no relevant differences in clinical improvement of subjective function and pain.