Effects Of Preoperative Depression On Postoperative Pain And Function In TKA Patients

ObjectiveWith the increasing incidence of knee osteoarthritis,total knee arthroplasty is becoming increasingly commonplace for the treatment of severe knee osteoarthritis.Although total knee arthroplasty can significantly improve the joint function and relieve knee pain,there are still quite a few patients who are not satisfied with the results.Among many reasons,mental factors such as depression are receiving more and more clinical attention.The aim of this study was to investigate the effects of preoperative depression on postoperative pain and joint function in patients undergoing total knee arthroplasty,and to provide theoretical support for the clinical search for appropriate analgesia patterns and rehabilitation methods.MethodsIn this prospective cohort study,we selected 85 patients with knee osteoarthritis who underwent unilateral total knee arthroplasty in the Department of Orthopaedics,Henan Provincial People’s Hospital from June 2017 to December 2017.Before surgery,patients should complet the Hospital Anxiety and Depression Scale(HAD),the Oxford Knee Score(OKS),and the Simplified McGill Pain Questionnaire(SF-MPQ).The patients were divided into two groups(depression group and non-depression group)based on the degree of psychologic depression on the HAD Scale.They were scored with OKS and SF-MPQ at 1 month,3 months,6 months,and 12 months after total knee arthroplasty.A total of 78 patients(92%)who participated in this study completed the entire follow-up process.ResultAfter 12 months of follow-up,the results were as follows:1.Before surgery,the OKS and SF-MPQ in the depression group were higher than those in the non-depression group,and the difference was statistically significant(P<0.01).2.Both the depression group and the non-depression group had significant improvement in OKS and SF-MPQ at the 12 th month after surgery,and the difference was statistically significant(P<0.01).3.The OKS scores of the depression group were higher than those of the non-depression group at 1 month,3 months,6 months and 12 months after surgery.The difference between the two groups was statistically significant(P<0.01).4.The SF-MPQ scores of the depression group was higher than that of the non-depression group at the 1 month and 3 month after surgery.The difference between the two groups was statistically significant(P<0.01).But at the 6th and 12 th months after surgery,there were no significant differences in SF-MPQ scores between the two groups(P>0.05).Conclution1.Total knee arthroplasty is an effective treatment for end-stage knee osteoarthritis,which can significantly improve knee function and relieve joint pain in patients with knee osteoarthritis.2.Preoperative depression can affect the recovery of postoperative function after total knee arthroplasty.3.Preoperative depression can affect the relief of knee pain at early period after total knee arthroplasty(within 6 months),but has no significant effect on knee pain at later period after total knee arthroplasty(after 6 months).