Guo EW, Cross AG, Hessburg L, Koolmees D, Bernstein DN, Elhage KG, Moutzouros V, Makhni EC. The Presence of Preoperative Depression Symptoms Does Not Hinder Recovery After Anterior Cruciate Ligament Reconstruction.
Orthop J Sports Med 2021;
9:2325967120970219. [PMID:
33786331 PMCID:
PMC7960906 DOI:
10.1177/2325967120970219]
[Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background:
The current literature suggests a link between psychosocial factors and poor surgical outcomes in patients with musculoskeletal complaints. However, there remains a limited body of literature examining the effect of depression on outcomes after anterior cruciate ligament reconstruction (ACLR).
Purpose:
The primary purpose of this study was to compare postoperative function patient-reported outcome scores between patients with and patients without preoperative depression symptoms undergoing ACLR. Secondary goals included comparing postoperative pain interference and depression scores between the 2 groups.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
In this single-center retrospective cohort study, pediatric and adult patients who underwent ACLR were included. The Physical Function (PF), Pain Interference (PI), and Depression (D) domain scores of the Patient-Reported Outcomes Measurement Information System (PROMIS) were collected preoperatively and at 6 and 12 months postoperatively. Patients were separated into clinical depression (CD) and no clinical depression (NCD) groups based on their preoperative PROMIS-D score.
Results:
A total of 82 patients undergoing ACLR were included in this study. Of these, 19 (23%) patients met criteria for the CD group. Preoperatively, the CD group reported lower mean PROMIS-PF (33.3 vs 39.7, respectively; P = .001), higher PROMIS-PI (65.7 vs 59.2, respectively; P <.01), and higher PROMIS-D (62.4 vs 45.1, respectively; P < .001) scores than the NCD group. At 12 months postoperatively, the mean PROMIS-PF scores for the CD and NCD groups were 52.1 and 56.7, respectively (P = .12). The mean 12-month postoperative PROMIS-PI scores for the CD and NCD groups were 52.3 and 47.4, respectively (P = .04). At 12 months after ACLR, there was a substantial improvement in PROMIS-PF and PROMIS-PI scores for both the CD (delta = +18.8 and –13.4, respectively) and NCD (delta = +17.0 and –11.8) groups.
Conclusion:
There was a significant improvement, which exceeded currently accepted minimal clinically important difference values, in PROMIS-PF scores at 12 months after ACLR, regardless of the presence of preoperative depression symptoms. These data suggest that having depression symptoms preoperatively does not significantly hinder a patient’s recovery after ACLR.
Collapse