[Does pre-surgical cognitive impairment affect knee replacement results?]

Area of Science:

• Orthopedic surgery
• Neuroscience
• Psychology

Background:

• Total knee arthroplasty (TKA) is a common procedure for osteoarthritis.
• Preoperative cognitive function may impact surgical outcomes and patient-reported results.
• Understanding this relationship is crucial for patient selection and management.

Purpose of the Study:

• To investigate the influence of preoperative cognitive impairment on TKA outcomes.
• To assess both physician and patient perspectives on TKA results in cognitively impaired individuals.

Main Methods:

• Prospective study of 215 patients undergoing primary TKA.
• Cognitive impairment assessed preoperatively using the Mini Cognitive Examination (MEC-35).
• Outcomes measured using VAS, KSS, WOMAC, and HADS preoperatively and one year postoperatively.

Main Results:

• No statistically significant difference in TKA outcomes (VAS, KSS, WOMAC) between patients with and without cognitive impairment.
• Patients with cognitive impairment exhibited significantly higher levels of anxiety and depression both preoperatively and one year postoperatively.
• All patients demonstrated improved quality of life and specific outcomes after TKA.

Conclusions:

• Preoperative cognitive impairment does not negatively influence the functional outcomes or quality of life following total knee arthroplasty.
• Cognitive impairment is associated with persistent higher levels of anxiety and depression, irrespective of TKA outcomes.