Infection and Mechanical Complications Are Risk Factors for New Diagnosis of a Mental Health Disorder After Total Joint Arthroplasty

Andrew Michael Figoni, MD; Gopal R. Lalchandani, MD; Alexander R. Markes, MD; David Sing, MD; Erik Nathan Hansen, MD

Arthroplasty Today (Aug 2021)

Infection and Mechanical Complications Are Risk Factors for New Diagnosis of a Mental Health Disorder After Total Joint Arthroplasty

Andrew Michael Figoni, MD,
Gopal R. Lalchandani, MD,
Alexander R. Markes, MD,
David Sing, MD,
Erik Nathan Hansen, MD

Affiliations

Andrew Michael Figoni, MD: Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
Gopal R. Lalchandani, MD: Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
Alexander R. Markes, MD: Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA; Corresponding author. 1500 Owens Street, San Francisco, CA 94158, USA. Tel.: +1 661 877 8735.
David Sing, MD: Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA, USA
Erik Nathan Hansen, MD: Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA

Journal volume & issue: Vol. 10
pp. 1 – 5

Abstract

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Background: Prior studies have demonstrated that depression is an independent risk factor for developing a prosthetic joint infection (PJI) after total joint arthroplasty (TJA). To our knowledge, there is no literature examining whether PJI or aseptic failure increases the risk of developing a new mental health diagnosis. Methods: PearlDiver Patient Database (Colorado Springs, CO) was used to identify 80,826 patients who underwent TJA without a pre-existing diagnosis of depression, anxiety, a stress and/or adjustment disorder, and/or current use of a selective serotonin reuptake inhibitor within the year prior to surgery. The odds of developing a new mental health issue or being prescribed a selective serotonin reuptake inhibitor within 1 year of an uncomplicated TJA was compared to those who developed PJI or mechanical failure within 90 days after TJA as well as to those who subsequently underwent revision surgery within 30 days of either complication using Fisher’s exact test and Baptista-Pike. Results: A total of 6474 (8%) patients were diagnosed with a new mental health issue after TJA. PJI or mechanical failure led to significantly higher odds of new diagnoses with an odds ratio of 1.67 (95% confidence interval = 1.26, 2.22) and 1.57 (1.24, 2.00), respectively. Undergoing revision surgery for PJI or mechanical failure increased the odds of developing a new mental health diagnosis to 2.10 (1.29, 3.42) and 2.24 (1.36, 3.72), respectively. There was no significant difference comparing those who developed PJI vs those who sustained mechanical complications. Conclusion: Patients who sustain complications after TJA are at increased odds of receiving a new mental health diagnosis, an effect further amplified if revision surgery is required.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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Abstract

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