Prevalence of Depressive Symptoms in Aseptic Revision Total Knee Arthroplasty Based on the Mode of Failure

Nicole Durig Quinlan, MD, MS; Vishal Hegde, MD; Daniel N. Bracey, MD, PhD; Aviva Pollet, MS; Roseann M. Johnson, BS, CCRP; Douglas A. Dennis, MD; Jason M. Jennings, MD, DPT

Arthroplasty Today (Feb 2024)

Prevalence of Depressive Symptoms in Aseptic Revision Total Knee Arthroplasty Based on the Mode of Failure

Nicole Durig Quinlan, MD, MS,
Vishal Hegde, MD,
Daniel N. Bracey, MD, PhD,
Aviva Pollet, MS,
Roseann M. Johnson, BS, CCRP,
Douglas A. Dennis, MD,
Jason M. Jennings, MD, DPT

Affiliations

Nicole Durig Quinlan, MD, MS: Colorado Joint Replacement at AdventHealth Porter, Denver, CO, USA
Vishal Hegde, MD: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Daniel N. Bracey, MD, PhD: Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC, USA
Aviva Pollet, MS: Colorado Joint Replacement at AdventHealth Porter, Denver, CO, USA
Roseann M. Johnson, BS, CCRP: Colorado Joint Replacement at AdventHealth Porter, Denver, CO, USA
Douglas A. Dennis, MD: Colorado Joint Replacement at AdventHealth Porter, Denver, CO, USA; Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, USA; Department of Biomedical Engineering, University of Tennessee, Knoxville, TN, USA
Jason M. Jennings, MD, DPT: Colorado Joint Replacement at AdventHealth Porter, Denver, CO, USA; Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA; Corresponding author. Colorado Joint Replacement, 2535 S. Downing Street, Ste 100, Denver, CO 80210, USA. Tel.: +1 720 524 1367.

Journal volume & issue: Vol. 25
p. 101298

Abstract

Read online

Background: Complications following total knee arthroplasty (TKA) that necessitate revision cause considerable psychological distress and symptoms of depression, which are linked to poorer postoperative outcomes, increased complications, and increased healthcare utilization. We aimed to identify the prevalence of mental health disorders and symptoms preoperatively and postoperatively in patients undergoing aseptic revision TKA and to stratify these patients based on their mechanism of failure. Methods: All patients undergoing aseptic revision TKA from 2008 to 2019 with a minimum 1-year follow-up were retrospectively reviewed at a single institution. Patients (n = 394) were grouped based on 7 failure modes previously described. Patients were considered to have depressive symptoms if their Veterans RAND-12 mental component score was below 42. Preoperative and postoperative Veterans RAND-12 mental component scores at the latest follow-up were evaluated. Results: Overall comparative prevalence of preoperative to postoperative depressive symptoms was 23.4%-18.8%. By mode of failure are as follows: arthrofibrosis (25.8%-16.7%), aseptic loosening (25.3%-18.9%), extensor mechanism disruption (25%-50%), failed unicompartmental knee arthroplasty (8.6%-14.3%), instability (25.7%-17.1%), osteolysis or polyethylene wear (23.1%-23.1%), and patellar failure (11.8%-23.5%). There was no difference in depressive symptoms among failure modes preoperatively (P = .376) or at the latest postoperative follow-up (P = .175). Conclusions: The prevalence of depressive symptoms in revision TKA patients appears to be independent of failure mode. Surgeon awareness and screening for depressive symptoms in this patient population preoperatively with referral for potential treatment may improve early postoperative outcomes.

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/

About the journal

Abstract

Keywords