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Influence of somatization and depressive symptoms on the course of pain within the first year after uncomplicated total knee replacement: a prospective study

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Abstract

Purpose

Approximately 10–25 % of patients are reportedly dissatisfied with the results of bicondylar knee prosthesis implantation. The purpose of this study was to evaluate the effect of depressive symptoms and particularly somatization dysfunction on outcomes after total knee replacement (TKR).

Methods

One hundred fifty patients were enrolled in this prospective study. Pre-operatively, depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and somatization was assessed using the PHQ-15. The primary outcome measure was self-assessed knee function evaluated with the Knee Osteoarthritis Outcome Score (KOOS). Pain was measured on a numerical rating scale (NRS). The secondary outcome measures were the KOOS subscales and patient satisfaction. Intergroup differences were tested using an independent t-test. The odds ratio was used to determine the probability of an unsatisfactory outcome.

Results

At 12 months post-operatively, patients with depressive symptoms and particularly patients with somatization dysfunction usually had a significantly higher NRS score at rest and during activities, a lower knee function before and after surgery, and higher dissatisfaction.

Conclusions

Psychopathologic factors, particularly somatization dysfunction, have an impact on TKR outcomes. Preoperative screening and concurrent treatment of the diagnosed psychological disorder may improve patient-perceived outcomes.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Martin Luther Hospital, Caspar Theyss Strasse 27–31, 14193, Berlin, Germany

    Sebastian Bierke, Martin Häner & Wolf Petersen

Authors
  1. Sebastian Bierke
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  2. Martin Häner
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  3. Wolf Petersen
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Corresponding author

Correspondence to Wolf Petersen.

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Conflict of interest

There are no financial conflicts related to the study.

Human studies

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (ethic vote nr.:EA1/305/13) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Bierke, S., Häner, M. & Petersen, W. Influence of somatization and depressive symptoms on the course of pain within the first year after uncomplicated total knee replacement: a prospective study. International Orthopaedics (SICOT) 40, 1353–1360 (2016). https://doi.org/10.1007/s00264-015-3105-z

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  • DOI: https://doi.org/10.1007/s00264-015-3105-z

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