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Postoperative Effects of Depression and Anxiety in Hip Arthroscopy at 2-Year Follow-up
Michael S Rocca1, Michael A McCurdy1, Isaiah Harris1
1Department of Orthopaedic Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Background:
Depression and anxiety are prevalent among patients undergoing hip arthroscopy. The influence of preoperative depression and anxiety on 2-year patient-reported outcomes (PROs) after hip arthroscopy is not currently known.
Hypothesis/Purpose:
The purpose of this study was to investigate the association between depression and anxiety on PROs after hip arthroscopy. It was hypothesized that worse baseline levels of depression and anxiety, or a clinical history of depression and anxiety, would be associated with worse functional status, pain, and satisfaction 2 years after hip arthroscopy.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients undergoing hip arthroscopy for femoroacetabular impingement and/or labral pathologies at a single institution from October 2015 to January 2020 were analyzed retrospectively. Levels of depression and anxiety were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety domains. Functional status, pain, activity levels, and satisfaction were also measured using PROMIS domains and other PRO measures. Bivariate analysis was conducted to assess associations between preoperative levels of depression and anxiety, as well as 2-year PROs.
Results:
Of the 92 patients identified, 65 (71%) completed follow-up. The mean (SD) baseline PROMIS Depression and Anxiety score was 50.6 (8.3) and 55.4 (8.9), respectively. Worse baseline PROMIS Depression and Anxiety were associated with worse PROMIS Fatigue, Depression, and Anxiety at 2 years but not associated with worse PROMIS Physical Function, Pain Interference, or Social Satisfaction. Unlike the PROMIS measures, a clinical history of depression or anxiety was not associated with PROMIS Fatigue.
Conclusion:
Among patients undergoing hip arthroscopy, worse preoperative mental health is associated with worse mental health outcomes at 2 years. However, preoperative mental health may have no bearing on postoperative functional status or satisfaction.
