Impact of preoperative mental health status on functional outcome 1 year after total hip arthroplasty
Parag Jaiswal, MD, Pam Railton, MSc, Hoa Khong, MD, MPH, Christopher Smith, MBA, and James Powell, MDHip
Background
The aim of this prospective cohort study was to determine the effect of preoperative mental health status on functional outcome 1 year after total hip arthroplasty (THA).
Methods
Data were collected for 677 patients from a randomized controlled trial in Alberta who received primary THA between April 2005 and June 2006 (sex, age, body mass index [BMI], comorbidities, back pain and need for another lower limb arthroplasty procedure within 1 yr after surgery). The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and 36-Item Short Form Health Survey (SF-36) mental health component were administered before surgery and 1 year after. We conducted multiple linear regression to determine the effect of mental health on the WOMAC score at 1 year.
Results
The mean WOMAC and SF-36 mental health scores were significantly increased at 1 year (p < 0.001 and p = 0.01, respectively). There was a strong correlation between improvement in WOMAC score at 1 year and presurgery SF-36 mental health score (0.13, 95% confidence interval [CI] 0.06 to 0.2). Age (−0.34, 95% CI −0.45 to −0.24), obesity (−2.9, 95% CI −5.32 to −0.4), back pain (−5.75, 95% CI −8.04 to −3.46) and awaiting another joint arthroplasty operation (−6.18, 95% CI −8.9 to −3.47) had a negative impact on the WOMAC score.
Conclusion
There was a strong correlation between presurgery mental health and the resolution of pain and improved functioning 1 year after THA. We recommend that patients receive appropriate counselling and, where appropriate, medical therapy before THA.
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