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Merry del Val B, Shukla SR, Oduoye MO, Nsengiyumva M, Tesfaye T, Glinkowski WM. Prevalence of mental health disorders in knee osteoarthritis patients: a systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:4705-4713. [PMID: 39118762 PMCID: PMC11305717 DOI: 10.1097/ms9.0000000000002258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/23/2024] [Indexed: 08/10/2024] Open
Abstract
Background Knee osteoarthritis (OA) is a prevalent degenerative disease affecting synovial joints, predominantly the knee, leading to various complications, including mental health conditions like depression and anxiety. This systematic review aimed to determine the prevalence of depression and anxiety in knee OA patients. Methods A comprehensive literature search was conducted in various databases till September 15, 2023. Studies focusing on the prevalence of mental health issues in patients with knee OA were included, excluding narrative reviews, protocols, unpublished reports, editorials, case reports, abstracts, and commentaries. All statistical analyses were performed in R version 4.2.3. Results This review included a total of 14 studies involving middle-aged to elderly adult patients with knee OA, with ages ranging from 45 to 75 years. Among these, 13 studies involving 3390 adult patients with an average age of 59.75 years reported a pooled prevalence of depression of 30% (95% confidence interval: 18-43), demonstrating a substantial heterogeneity (I 2=98%). Additionally, anxiety was identified with a combined prevalence of 27% (95% confidence interval: 24-30) based on three studies that included 1407 older adult patients with an average age of 62.1 years. These studies displayed minimal heterogeneity (I 2=7%). Conclusion The findings show a significant prevalence of depression among adult patients with knee OA and anxiety among older adults with knee OA, emphasizing the need for integrated healthcare approaches that address both orthopedic and mental health conditions. More comprehensive research is essential to deepen our understanding of the connection between mental illnesses and knee OA and to develop effective preventive and treatment strategies.
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Affiliation(s)
- Borja Merry del Val
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
| | - Saurin R. Shukla
- GMERS Medical College, S.G. highway, Sola, Ahmedabad, Gujarat, India
| | - Malik O. Oduoye
- Department of Research, The Medical Research Circle (MedReC), Goma, DR Congo
| | | | | | - Wojciech M. Glinkowski
- Department of Medical Informatics and Telemedicine, Center of Excellence “TeleOrto” for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, Warsaw, Poland
- Stichting MED PARTNERS, Amsterdam, Noord-Holland, the Netherlands
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Kim JT, Koo KH. The Long-Term View-Assessing Life Expectancy Post-Knee Arthroplasty: A Commentary on "Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population". J Korean Med Sci 2024; 39:e112. [PMID: 38529579 DOI: 10.3346/jkms.2024.39.e112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024] Open
Affiliation(s)
- Jung-Taek Kim
- Department of Orthopaedic Surgery, Ajou University School of Medicine, Ajou Medical Center, Suwon, Korea
| | - Kyung-Hoi Koo
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Kay Joint Center at Cheil Orthopaedic Hospital, Seoul, Korea.
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Colovic D, Draschl A, Reinbacher P, Hecker A, Schittek G, Fischerauer SF, Leithner A, Klim SM, Koutp A, Wittig U, Brunnader K, Sandner-Kiesling A, Sadoghi P. Evaluation of Neuropathic Pain after Total Knee Arthroplasty: Do Yellow Flags Matter? J Clin Med 2023; 12:7708. [PMID: 38137778 PMCID: PMC10743389 DOI: 10.3390/jcm12247708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Up to 20% of total knee arthroplasty (TKA) patients continue to experience chronic postsurgical pain. Various factors have been identified as potential contributors, including so-called "yellow flags", encompassing symptoms of depression, anxiety, and catastrophizing, which were examined in this study to assess their predictive value concerning functional outcomes after TKA. METHODS Fifty TKA patients were categorized into high-risk and low-risk groups based on clinical assessment, demographic data, medication, and patient-reported outcome measures (DN4, SF-36, WOMAC, NRS, Fibromyalgia Survey Questionnaire, Pain Catastrophizing Scale, and Hospital Anxiety and Depression Scale). Postoperative outcomes within six months after TKA were then compared. RESULTS Both groups exhibited significant (p < 0.001) improvements in all WOMAC and NRS subscales, as well as in the physical function, role physical, pain, and energy/fatigue subdomains of the SF-36 after six months, while the high-risk group showed lower WOMAC scores regarding stiffness (19.0 ± 18.3 vs. 27.2 ± 20.7, p < 0.001) and pain (13.5 ± 13.3 vs. 15.1 ± 16.3, p = 0.029). The high-risk group showed significantly worse preoperative DN4 scores (1.8 ± 1.3 vs. 3.0 ± 1.1, p = 0.002) than the low-risk group, which persisted for one day (2.3 ± 1.2 vs. 3.5 ± 1.5, p = 0.005) and six weeks (2.2 ± 1.9 vs. 3.6 ± 2.3, p = 0.041) postoperatively. CONCLUSIONS Our results indicate that pre-existing yellow flags contribute to a more challenging early postoperative phase, underscoring the importance of considering individual patient characteristics and psychological factors to optimize TKA outcomes.
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Affiliation(s)
- Danijel Colovic
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Alexander Draschl
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036 Graz, Austria
- COREMED—Centre for Regenerative Medicine and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, 8010 Graz, Austria
| | - Patrick Reinbacher
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036 Graz, Austria
- COREMED—Centre for Regenerative Medicine and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, 8010 Graz, Austria
| | - Gregor Schittek
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5/5, 8036 Graz, Austria;
| | - Stefan Franz Fischerauer
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Andreas Leithner
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Sebastian Martin Klim
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Amir Koutp
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Ulrike Wittig
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Kevin Brunnader
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
| | - Andreas Sandner-Kiesling
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5/5, 8036 Graz, Austria;
| | - Patrick Sadoghi
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria; (D.C.); (P.S.)
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Choi YS, Park JW, Kim TW, Kang KS, Lee YK, Koo KH, Chang CB. Effect of Total Hip Arthroplasty on Ipsilateral Lower Limb Alignment and Knee Joint Space Width: Minimum 5-Year Follow-up. J Korean Med Sci 2023; 38:e148. [PMID: 37218351 DOI: 10.3346/jkms.2023.38.e148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/12/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND This study aimed to 1) assess the effect of total hip arthroplasty (THA) on coronal limb alignment, namely, the hip-knee-ankle angle (HKA), 2) identify factors that determine changes in the HKA, and 3) determine whether alignment changes influence the knee joint space width. METHODS We retrospectively evaluated 266 limbs of patients who underwent THA. Three types of prostheses with neck shaft angles (NSAs) of 132°, 135°, and 138° were used. Several radiographic parameters were measured in the preoperative and final radiographs (at least 5 years after THA). A paired t-test was used to confirm the effect of THA on HKA change. Multiple regression analysis was performed to identify radiographic parameters related to HKA changes following THA and changes in knee joint space width. Subgroup analyses were performed to reveal the effect of NSA change on the HKA change, and the proportion of total knee arthroplasty usage and changes in radiographic parameters between maintained joint space and narrowed joint space groups were compared. RESULTS The preoperative mean HKA was 1.4° varus and increased to 2.7° varus after THA. This change was related to changes in the NSA, lateral distal femoral angle, and femoral bowing angle. In particular, in the group with a decrease in NSA of > 5°, the preoperative mean HKA was largely changed from 1.4° varus to 4.6° varus after THA. The prostheses with NSA of 132° and 135° also led to greater varus HKA changes than those with an NSA of 138°. Narrowing of the medial knee joint space was related to changes in the varus direction of the HKA, decrease in NSA, increase in femoral offset. CONCLUSION A large reduction in NSA can lead to considerable varus limb alignment after THA, which can have adverse effects on the medial compartment of the ipsilateral knee.
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Affiliation(s)
- Yun Seong Choi
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Korea
| | - Jung-Wee Park
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Woo Kim
- Department of Orthopedic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kee Soo Kang
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Kay Joint Center, Cheil Orthopaedic Hospital, Seoul, Korea
| | - Chong Bum Chang
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
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