CME OnDemand: 2022 AOFAS Annual Meeting-The Effects of Anxiety and Depression in Outcomes of Patients with Total Ankle Replacement

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A retrospective chart review was conducted to study the effects of anxiety and depression on post-operative pain control following total ankle arthroplasty (TAA). Patients were divided into two groups: Group A consisted of patients with no history of anxiety or depression, and Group B consisted of patients with a documented pre-operative history of anxiety or depression. Demographic data were collected, and electronic medical records were reviewed at 2- and 6-weeks post-surgery to determine post-operative pain levels. The relative risk of poorly-controlled post-operative pain in patients with anxiety and depression was analyzed statistically.<br /><br />Previous studies have shown that pre-operative factors such as anxiety, depression, and poor coping skills can be associated with worse outcomes following joint replacement surgery. However, the specific association between anxiety and depression and patient-reported outcomes following TAA is not well-defined.<br /><br />In this study, the cohort of 56 patients who underwent TAA showed no significantly increased risk for poor pain control in patients with a history of anxiety and depression. Both Group A and Group B had four patients reporting poor pain control, indicating that anxiety and depression did not have a significant impact on post-operative pain levels.<br /><br />Limitations of the study include the small sample size, not controlling for potential comorbid patient factors, relying on subjective patient perspectives, and not considering the severity of anxiety and depression or previous treatment in data analysis.<br /><br />Future directions for research include expanding the study with a larger sample size, conducting multi-variable analyses to evaluate the compounding effects of patient factors on pain control, investigating the impact of psychological intervention or medical treatment of anxiety and depression before TAA, and exploring the effects of anxiety and depression on other post-operative outcomes.<br /><br />Overall, this study suggests that a history of anxiety and depression does not increase the risk of poorly-controlled post-operative pain following TAA.

Asset Subtitle

Hannah Nam, Brandon J. Martinazzi, BS, Gregory Kirchner, Vincenzo, Bonaddio, MD, Zachary Koroneos, BS, Kristen Manto, PhD, Anna Ptasinski, Michael C. Aynardi, MD

Keywords

retrospective chart review

anxiety

depression

post-operative pain control

total ankle arthroplasty

patient-reported outcomes

joint replacement surgery

small sample size

patient factors

psychological intervention