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

Area of Science:

• Orthopaedic Surgery
• Psychiatry
• Rehabilitation Medicine

Background:

• Mental health is crucial for patient-reported outcomes (PROs) in surgery.
• Limited research exists on PROMIS depression and anxiety in knee surgery patients.
• Preoperative and postoperative mental health status can affect surgical results.

Purpose of the Study:

• Assess depression and anxiety prevalence before and after elective knee surgery.
• Determine the influence of these mental health symptoms on postoperative functional outcomes.
• Evaluate the utility of PROMIS computer adaptive tests in this patient population.

Main Methods:

• Retrospective query of an orthopaedic registry for elective knee surgery patients (2015-2018).
• Prospective data collection via pre- and postoperative electronic surveys including PROMIS depression, anxiety, IKDC, and PROMIS PF.
• Statistical analysis using Wilcoxon rank sum, Spearman's correlation, and multivariable analysis.

Main Results:

• Average PROMIS depression and anxiety scores improved significantly two years post-surgery.
• Depression and anxiety scores correlated with each other and with functional outcomes (PROMIS PF, IKDC).
• Worse postoperative anxiety predicted less functional improvement; worse depression predicted poorer IKDC scores, even after controlling for confounders.

Conclusions:

• Confirms a strong link between mental health and functional recovery after knee surgery.
• Identifying and treating psychiatric comorbidities may enhance orthopaedic outcomes.
• Postoperative depression and anxiety can impede optimal functional recovery, necessitating PROMIS assessment.