Improvements in physical function and pain sustained for up to 10 years after knee or hip arthroplasty irrespective of mental health status before surgery

Abstract

Background and purposeThere are concerns that mental health (MH) may influence outcomes of total knee arthroplasty (TKA) or total hip arthroplasty (THA). We examined effects of poor MH before surgery on long-term outcomes of osteoarthritis-related TKA or THA in women.Patients and methodsThe data were from 9,737 middle-aged participants (47–52 years) and 9,292 older participants (73–78 years) in the Australian Longitudinal Study on Women’s Health who completed surveys between 1998 and 2013. Dates of arthroplasties were obtained from the Australian Orthopaedics Association National Joint Replacement Registry. Participants without procedures were matched with participants with procedures. Trajectories of the Short-Form 36 scores for physical functioning, bodily pain, social functioning, and mental health based on mixed modeling were plotted for participants with and without surgery (stratified according to mental health, separately for TKA and THA, and for middle-aged and older participants).ResultsIn middle-aged women with poor and good MH, TKA improved physical function and reduced bodily pain, with improvements sustained up to 10 years after surgery. TKA contributed to restoration of social function in women with good MH, but this was less clear in women with poor MH. In both MH groups, mental health appeared to be unaffected by TKA. Similar patterns were observed after THA, and in older women.InterpretationRecovery of physical and social function and reductions in pain were sustained for up to 10 years after surgery. Improvements in physical function and pain were also observed in women with poor mental health. Thus, in our view poor mental health should not be a contraindication for arthroplasty.

Mental Health and Total Knee Arthroplasty

“…Perhaps, mental health should be viewed as being dynamic and negatively affected by pain and physical limitation caused by knee arthritis 10 . This supports that despite the reports of lower mental health scores, these patients still show a benefit from having a TKA 23 .…”

Poor Performance on a Preoperative Cognitive Screening Test Predicts Postoperative Complications in Older Orthopedic Surgical Patients

“…In the event of a disagreement, a third investigator scored the test and served as a tie-breaker. Patients also completed the 1) short form 36 health survey, 22 an index of quality of life across eight domains (physical functioning, limitations due to physical health or emotional problems, energy/fatigue, emotional well-being, social functioning; pain, general health); 2) geriatric depression scale short form; 23 3) activities of daily living; 24 and 4) instrumental activities of daily living. 25 We also measured grip strength as an index of frailty using a Jamar Dynamometer 26 and obtained baseline data on age, weight, gender, highest level of education, American Society of Anesthesiologists (ASA) functional status, Metabolic Equivalent of Task, 27 and type of surgical procedure from the medical record.…”

Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study

“…The advent of disease-modifying anti-rheumatic drugs has been pivotal in the treatment of RA, yet patients may still be hindered by debilitating joint pain (Ishida et al, 2018 ). Control of chronic joint pain remains a difficult feat, and patients commonly resort to surgical options such as total joint arthroplasty once nonoperative modalities have failed (Breivik et al, 2006 ; Geeske Peeters et al, 2017 ; Peter et al, 2015 ).…”