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Depression and somatisation influence the outcome of total hip replacement

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Abstract

Depression, somatisation and pain beliefs influence outcome of several painful musculoskeletal disorders. Their influence on the postoperative outcome of total hip replacement was investigated. A total of 79 patients who underwent primary total hip replacement completed questionnaires preoperatively and six weeks postoperatively addressing depression (Hospital Anxiety and Depression Scale–German version), pain beliefs (Pain Beliefs Questionnaire) and somatisation (Screening of Somatoform Disorders-2) as well as outcome [Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcomes Study 36-Item Short Form (SF-36)]. Depressive patients showed a median preoperative WOMAC sum score of 30 compared to 45 in other patients and a postoperative score of 72 compared to 85, and patients with somatoform disorder of 32 compared to 46 preoperatively and 73 versus 86 postoperatively. Patients with high somatisation and depression scores feel worse in their hips and in general well-being before and after surgery, but they experienced the same benefit from total hip replacement as those with low scores.

Résumé

La dépression due à la somatisation et les douleurs résiduelles peuvent influencer le devenir instantané des troubles musculo-squelettique douloureux des prothèses totales de hanches. 79 patients ont bénéficié d’une prothèse totale de hanche et ont rempli un questionnaire préopératoire et à six mois post-opératoire en ce qui concerne la dépression (HADS-D), les douleurs résiduelles (Pain Beliefs Questionnaire) et la somatisation (SOMS-2). Ils ont également rempli le questionnaire WOMAC et le SF-36. Les patients dépressifs montrent un score moyen WOMAC à 30 et ceci peut être comparé au score de 45 pour les autres patients en préopératoire. En postopératoire le score est à 72 comparé aux autres patients qui sont à 85. Les patients somatisant leurs problèmes ont un résultat à 32 comparés à 46 en préopératoire de même en postopératoire, 76 versus 86. Les patients qui présentent une somatisation importante avec une dépression ont une aggravation de leur score avant et après l’intervention mais ils auront le même bénéfice de la prothèse totale de hanche que ceux qui ont un score inférieur.

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Authors and Affiliations

  1. LKH Bregenz, Department of General Surgery, Carl-Pedenz-Strasse 2, 6900, Bregenz, Austria

    Wolfgang Riediger

  2. Department of Psychosomatic in Dental Medicine, Poliklinik für Zahnärztliche Prothetik, Universitätsklinikum Münster, Waldeyerstrasse 30, 48149, Muenster, Germany

    Stephan Doering

  3. Department of Orthopaedics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Martin Krismer

Authors
  1. Wolfgang Riediger
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  2. Stephan Doering
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  3. Martin Krismer
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Correspondence to Martin Krismer.

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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Riediger, W., Doering, S. & Krismer, M. Depression and somatisation influence the outcome of total hip replacement. International Orthopaedics (SICOT) 34, 13–18 (2010). https://doi.org/10.1007/s00264-008-0688-7

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  • DOI: https://doi.org/10.1007/s00264-008-0688-7

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