Patients With Preoperative Clinical Depression Symptomology Experience Significant Improvements in Postoperative Pain, Function, and Depressive Symptoms Following Rotator Cuff Repair

Hessburg, Luke; Ziedas, Alexander; Cross, Austin G.; Elhage, Kareem; Guo, Eric W.; Yedulla, Nikhil R; Koolmees, Dylan; Muh, Stephanie J.; Moutzouros, Vasilios; Makhni, Eric C.

doi:10.1016/j.arthro.2021.05.020

Cited by 8 publications

(10 citation statements)

References 35 publications

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“…23,24 Previous studies have reported similar findings in cohorts of ACL and RCR patients. 25,26 Further studies on this finding are warranted.…”

Section: Accepted Manuscriptmentioning

confidence: 89%

Patient-Reported Outcome Measurement Information System Depression and Anxiety in Elective Knee Surgery Patients

Kaveeshwar,

Schneider,

Kung

et al. 2023

J Knee Surg

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INTRODUCTION: Mental health has been shown to play an important role in patient-reported outcomes (PRO), however, there is a general lack of literature describing Patient-Reported Outcome Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests in elective knee surgery patients. The purpose of our study was to assess the prevalence of depression and anxiety symptoms before and after elective knee surgery, and to determine whether these symptoms influence postoperative functional outcomes. METHODS: An institutional review board-approved prospective orthopaedic registry was retrospectively queried for patients undergoing elective knee surgery from June 2015 to November 2018. Electronic surveys collecting patient demographic information and PROs were administered pre and postoperatively. Of the 663 patients that completed baseline questionnaires, 466 completed two-year follow-up (70.3%). PROs included PROMIS Depression, PROMIS Anxiety, International Knee Documentation Committee Subjective Knee Form (IKDC) and PROMIS Physical Function (PF). Wilcoxon Rank Sum and Spearman’s Rank Order Correlation were utilized to determine associations between variables. Multivariable analysis was used to control for confounding variables. RESULTS: Average PROMIS Depression and Anxiety scores significantly improved two years after surgery. PROMIS Depression and Anxiety scores significantly correlated with each other. PROMIS Depression and Anxiety scores significantly correlated with PROMIS PF and IKDC scores. After controlling for confounders on multivariable analysis, worse two-year PROMIS Anxiety was predictive of less functional improvement and worse two-year PF and IKDC, while worse two-year PROMIS Depression was predictive of less improvement in IKDC. CONCLUSION: This study confirms the important relationship between mental health and functional outcomes. Given that psychiatric comorbidities are potentially modifiable with treatment, proper recognition could potentially lead to better orthopaedic outcomes. In addition, the prevalence of depression and anxiety symptoms postoperatively, as documented by PROMIS computer adaptive tests, may act as a barrier to achieving optimal functional outcomes after elective knee surgery. Level of Evidence: Level III Keywords: PROMIS, Knee, Depression, Anxiety, Patient-Reported Outcomes

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“…23,24 Previous studies have reported similar findings in cohorts of ACL and RCR patients. 25,26 Further studies on this finding are warranted.…”

Section: Accepted Manuscriptmentioning

confidence: 89%

Patient-Reported Outcome Measurement Information System Depression and Anxiety in Elective Knee Surgery Patients

Kaveeshwar,

Schneider,

Kung

et al. 2023

J Knee Surg

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“…This is consistent with recent studies published by Hessburg et al and Lau et al which found patients with DA undergoing RCR show significant improvements in both pain and functional scores. 10 , 14 This study categorized patients by the presence of a diagnosis of depression or anxiety at the time of surgery; we were unable to assess the severity or clinical significance of symptoms in individual patients, although we did attempt to correct for this somewhat based on the use of PM at the time of surgery and found no differences in outcomes between patients with DA on or off medication. A recent study by Park et al categorized patients based on the results of the Hospital Anxiety and Depression Score (HADS) performed preoperatively and found that patients with psychological distress at the time of surgery had increased pain and slower improvements in ROM, although the long-term outcomes of RCR were similar to the group with healthy psychological status.…”

Section: Discussionmentioning

confidence: 99%

Effects of preexisting depression and anxiety on postoperative outcomes following arthroscopic rotator cuff repair

Johnson¹,

York²,

Lashgari³

et al. 2022

JSES International

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“…Patients with a diagnosis of a psychiatric disease have been shown to have worse outcomes after undergoing orthopaedic procedures [27][28][29][30][31][32][33][34][35] . Paradoxically, those with depressive symptoms and low PROMIS-D (depression) scores preoperatively may also demonstrate substantial improvement in depressive symptoms following interventions 29,36,37 , which indicates the impact that musculoskeletal conditions can have on a patient's mental well-being.…”

Section: Mental Health Screeningmentioning

confidence: 99%

AOA Critical Issues: Patient-Reported Outcome Measures

Makhni

Hennekes

Baumhauer

et al. 2023

Journal of Bone and Joint Surgery

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:Patient-centered care is essential to providing high-quality value-based care. Patient-reported outcome measures (PROMs) are arguably the best tools available to orthopaedic providers for providing patient-centered care. Many clinical opportunities exist for the implementation of PROMs into routine practice, such as shared decision-making, mental health screening, and prediction of postoperative disposition. Routine use of PROMs is also an adjunct to the streamlining of documentation, patient intake, and telemedicine visits, and hospitals can aggregate PROMs for the purpose of risk stratification. Physicians can harness the power of PROMs for quality improvement initiatives and improvement of the patient experience. Despite these numerous applications, PROMs are frequently underutilized tools. Understanding the many benefits of PROMs may allow orthopaedic practices to justify investing in these valuable tools.

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Patients With Preoperative Clinical Depression Symptomology Experience Significant Improvements in Postoperative Pain, Function, and Depressive Symptoms Following Rotator Cuff Repair

Cited by 8 publications

References 35 publications

Patient-Reported Outcome Measurement Information System Depression and Anxiety in Elective Knee Surgery Patients

Patient-Reported Outcome Measurement Information System Depression and Anxiety in Elective Knee Surgery Patients

Effects of preexisting depression and anxiety on postoperative outcomes following arthroscopic rotator cuff repair

AOA Critical Issues: Patient-Reported Outcome Measures

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