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Depression and anxiety are associated with worse baseline function in hip arthroscopy patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to analyze the correlation between baseline depression and anxiety and preoperative functional status in hip arthroscopy patients.

Methods

A prospective, institutional review board-approved orthopaedic registry was used to retrospectively study 104 patients undergoing hip arthroscopy. Enrolled patients were administered baseline questionnaires for Patient-Reported Outcomes Measurement Information System (PROMIS) domains, Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) preoperative expectations, and Numeric Pain Scale (NPS).

Results

The average baseline PROMIS Depression and Anxiety scores were 49.9 ± 9.8 and 55.5 ± 9.3, respectively. Bivariate analysis demonstrated that greater baseline PROMIS Anxiety correlated with worse preoperative PROMIS PI (p < 0.001), Fatigue (p < 0.001), Social Satisfaction (p < 0.001), and NPS score (p = 0.013). Bivariate analysis showed that greater PROMIS Depression correlated with worse preoperative PROMIS PF (p = 0.001), PI (p < 0.001), Fatigue (p < 0.001), SS (p < 0.001), and NPS score (p = 0.004). After controlling for confounders, multivariable analysis confirmed increased PROMIS Depression as an independent predictor of worse preoperative PROMIS PF (p = 0.009), MODEMS Expectations (p = 0.025), and NPS score (p = 0.002). Increased PROMIS Anxiety was predictive of worse baseline PROMIS PI (p < 0.001), Fatigue (p < 0.001), and Social Satisfaction (p < 0.001). A previous clinical diagnosis of depression or anxiety was only an independent predictor of worse baseline PROMIS Fatigue (p = 0.002) and was insignificant in all other models.

Conclusion

Increasing severity of depression and anxiety correlated with and predicted worse functional status at baseline in hip arthroscopy patients. As compared to clinical diagnosis of anxiety and depression, PROMIS metrics have superior utility in recognizing potentially modifiable mental health concerns that predict worse preoperative status. Ultimately, the study identifies an at-risk population undergoing hip arthroscopy that requires particular attention and potential mental health intervention in the preoperative setting.

Level of evidence

III.

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Acknowledgements

J. Kathleen Tracy, Ph.D.; Ali Aneizi, MD; Andrew G. Dubina, MD; Julio J. Jauregui, MD; Vidushan Nadarajah, MD; Patrick M.J. Sajak MD: Tina Zhang MD; Joshua M. Abzug, MD; Ngozi M. Akabudike, MD; Craig H. Bennett, MD; W. Andrew Eglseder, MD; Mohit N. Gilotra, MD; S. Ashfaq Hasan, MD; Natalie Leong, MD; Christopher G. Langhammer, MD; Vincent Ng, MD; Jonathan D. Packer, MD; Ebrahim Paryavi, MD; Raymond A. Pensy, MD; Cameran I. Burt; Shaun H. Medina; Keyan Shasti; Dominic J. Ventimiglia; Alexander J. Wahl; and Michael P. Smuda for their assistance with data collection.

Funding

This work was supported by a grant from The James Lawrence Kernan Hospital Endowment Fund, Incorporated. Grant number: BL1941007WS.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Maryland School of Medicine, 2200 Kernan Drive, Baltimore, MD, 21207, USA

    Samir Kaveeshwar, Michael P. Rocca, Brittany A. Oster, Matheus B. Schneider, Andrew Tran, Matthew P. Kolevar, Farshad Adib, R. Frank Henn III & Sean J. Meredith

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  1. Samir Kaveeshwar
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  2. Michael P. Rocca
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Contributions

SK and MBS participated in data extraction and analysis. SK, MR, BO, AT, and MK participated in manuscript drafting, table production, and editing/revision. MBS, FA, RFH participated in manuscript editing and finalization. SJM participated in project conceptualization, oversight, manuscript editing and finalization. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sean J. Meredith.

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Conflict of interest

None relevant to the submitted work.

Ethical approval

University of Maryland, Baltimore IRB approval was obtained for this project: HP-00062261. All study participants provided informed consent.

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Kaveeshwar, S., Rocca, M.P., Oster, B.A. et al. Depression and anxiety are associated with worse baseline function in hip arthroscopy patients. Knee Surg Sports Traumatol Arthrosc 30, 3563–3569 (2022). https://doi.org/10.1007/s00167-022-06963-y

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