Effects of Perioperative Selective Serotonin Reuptake Inhibitor Use in Primary Total Hip and Knee Arthroplasty

Bourget-Murray, Jonathan; Parkar, Asif; Railton, P.; Evaniew, Nathan; Powell, James

doi:10.1016/j.arth.2021.11.013

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…This risk is thought to occur through downregulation of platelet aggregation. 34 Bourget-Murray et al 35 similarly reported higher rates of blood transfusion associated with perioperative SSRI utilization. An interesting observation in their study was that 11.3% of TKA and 13.3% of THA patients stopped using SSRIs at 12 months after arthroplasty.…”

Section: Discussionmentioning

confidence: 97%

Treatment of Concurrent Depression and Its Effect on Outcomes After Total Joint Arthroplasty: A Systematic Review of Comparative Studies

Morgan,

Shahabi,

Kruse

et al. 2023

J Am Acad Orthop Surg

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Purpose: There is a growing body of evidence suggesting that patients with a diagnosis of depression suffer worse outcomes after total joint arthroplasty (TJA) procedures. It is unclear whether depression treatment is a modifiable risk factor that can be targeted to improve suboptimal outcomes. We conducted a systematic review to understand the role that various interventions have on outcomes of TJA in patients with diagnosed depression (PDDs). Methods: PubMed, Ovid MEDLINE, Scopus, and EMBASE were searched systematically from inception until November 2022. Studies of PDDs who underwent TJA that compared any intervention/treatment of depression with a control group and reported pain, functional outcomes, depression scores, and/or revision rates after TJA were relevant for this review. Results: Ten relevant studies were included in the final systematic review, with a total of 33,501 patients included. Two studies reported lower revision rates for patients receiving selective serotonin reuptake inhibitor treatment and psychotherapy. Two studies showed no difference in functional outcomes for patients receiving pharmacologic treatment. One study reported improved functional outcomes for patients receiving cognitive behavioral therapy and another reported improved postoperative functional outcomes for patients receiving alprazolam. Conclusion: Interventions targeted at PDDs may improve short-term pain and functional outcomes, and there may be an association between selective serotonin reuptake inhibitor use and implant survival. The current literature is limited and inconclusive, with important gaps in understanding regarding the optimization and treatment of this modifiable risk factor. Surgeons should consider depression treatment as a method to improve outcomes in this cohort.

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Section: Discussionmentioning

confidence: 97%

Treatment of Concurrent Depression and Its Effect on Outcomes After Total Joint Arthroplasty: A Systematic Review of Comparative Studies

Morgan,

Shahabi,

Kruse

et al. 2023

J Am Acad Orthop Surg

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“…EuroQol-5 Dimensions [EQ-5D] and EuroQol Visual Analogue Scale [EQ VAS]) 12 months after hip and knee replacement. 14,15 No evidence-based guidelines for perioperative management of SSRIs/SNRIs in replacement patients exist. 2 Auerbach et al have proposed that temporary discontinuation of SSRIs in the perioperative period may be beneficial.…”

Section: Mcmaster Universities Arthritis Index [Womac]mentioning

confidence: 99%

“…11 Additionally, research in hip and knee replacement has shown that SSRIs increases the risk of allogenic red blood cell transfusions, which is an important risk factor for surgical site infection. [12][13][14] Finally, studies have indicated that SSRI users have worse patient-reported outcomes (Western Ontario and…”

Section: Introductionmentioning

confidence: 99%

“…The risk of bleeding is of particular interest in a surgical setting where treatment with SSRIs have been associated with increased risk of adverse events including bleeding after major surgery 11 . Additionally, research in hip and knee replacement has shown that SSRIs increases the risk of allogenic red blood cell transfusions, which is an important risk factor for surgical site infection 12–14 . Finally, studies have indicated that SSRI users have worse patient‐reported outcomes (Western Ontario and McMaster Universities Arthritis Index [WOMAC], EuroQol‐5 Dimensions [EQ‐5D] and EuroQol Visual Analogue Scale [EQ VAS]) 12 months after hip and knee replacement 14,15 …”

Section: Introductionmentioning

confidence: 99%

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Psychopharmacological treatment in patients planned for hip or knee replacement

Kornvig,

Kehlet,

Jørgensen

et al. 2024

Basic Clin Pharma Tox

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Psychopharmacological treatment may be an independent risk factor for increased length of stay and readmission after hip and knee replacement. Thus, temporary perioperative discontinuation may be beneficial. However, little is known regarding the treatments, and not all are feasible to discontinue. Therefore, the aim of this study was to describe the treatments in terms of type, dose, duration, indication and initiating physician to assess the feasibility of temporary perioperative discontinuation. We included 482 patients planned for hip or knee replacement in psychopharmacological treatment for psychiatric disorders from 2021 to 2023 at five orthopaedic departments in Denmark. Most patients were treated with antidepressants (89%); most frequently, either selective serotonin reuptake inhibitors (SSRIs; 48%) or serotonin‐norepinephrine reuptake inhibitors (SNRIs; 21%). The majority received monotherapy (70%); most frequently, an SSRI (36%) or an SNRI (12%). Most antidepressants were initiated by general practitioners (71%), and the treatments had lasted for more than a year (87%). The doses of SSRIs/SNRIs were moderate, and the most frequent indication for antidepressants was depression (77%). These results imply that temporary perioperative SSRI/SNRI discontinuation may be feasible in hip and knee replacement patients and support a future randomized controlled trial investigating the potential benefits of temporary discontinuation.

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Allgemeine Aspekte in präoperativen – intraoperativen – postoperativen Abschnitten

Kapfhammer

2023

Depression, Angst Und Traumatischer Stress in Der Chirurgie

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Effects of Perioperative Selective Serotonin Reuptake Inhibitor Use in Primary Total Hip and Knee Arthroplasty

Cited by 4 publications

References 29 publications

Treatment of Concurrent Depression and Its Effect on Outcomes After Total Joint Arthroplasty: A Systematic Review of Comparative Studies

Treatment of Concurrent Depression and Its Effect on Outcomes After Total Joint Arthroplasty: A Systematic Review of Comparative Studies

Psychopharmacological treatment in patients planned for hip or knee replacement

Allgemeine Aspekte in präoperativen – intraoperativen – postoperativen Abschnitten

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