Risk Factors for Development of New-onset Anxiety and Depression After Sports Medicine Surgeries in Patients 25 Years of Age or Younger

The purpose of this study was to evaluate the incidence of new-onset anxiety and depression (NOAD) in younger patients undergoing common sports medicine procedures, determine risk factors associated with NOAD, and identify which treatments are used.

A retrospective review of the PearlDiver national database was done. All patients included had no diagnosis of depression or anxiety before undergoing the following surgical procedures: anterior cruciate ligament reconstruction (ACLR), meniscus repair, hip arthroscopy (HA), shoulder instability repair, rotator cuff repair, or Achilles tendon repair. All patients were 25 years or younger and had ≥1-year follow-up. The primary outcome was development of NOAD within 1 year postoperatively. Multivariate regression was used to assess risk factors for NOAD.

A total of 178,759 patients were included in this study. Overall, 8,900 (5.0%) of patients developed NOAD within 1 year postoperatively; HA patients had the highest rate of NOAD (8.43%). Logistic regression identified age (P < 0.001), female sex (P < 0.001), Charlson Comorbidity Index score (P < 0.001), alcohol disorders (P < 0.001), headaches/migraines (P < 0.001), obesity (P < 0.001), and tobacco use (P < 0.001) as predictors of NOAD. Compared with ALCR, HA patients (OR, 1.81; P < 0.001) had the greatest risk of developing NOAD.

The incidence of NOAD in the first year after common sports medicine procedures was 5% for patients aged 25 years or younger. Increased age, substance use, comorbidities, and HA were identified as risk factors for NOAD. Additional study of both mental health and functional outcomes, prevention, and treatment strategies is required to elucidate the risk of NOAD.