Patients With Mood Disorders Have Higher Rates of Health Care Utilization, Medical Complications, Opioid Prescriptions, and Subsequent Knee Surgery After Arthroscopic Partial Meniscectomy.

Abstract

Purpose: To compare rates of postoperative complications, health care utilization, opioid prescribing patterns, and secondary knee surgery in patients with versus without a pre-existing anxiety or depressive disorder (ADD) undergoing isolated primary arthroscopic partial meniscectomy (APM).

Methods: The TriNetX database was queried from inception to compare patients older than 18 years who underwent isolated primary APM with versus without a pre-existing ADD. Patients were matched in a 1:1 ratio based on demographic factors and comorbidities, including diabetes and hypertension. The following outcomes were collected: (1) postoperative complications and health care utilization within 90 days, (2) proportion of patients prescribed an opioid within 1 year, and (3) subsequent knee surgery within 2 years, specifically ipsilateral or contralateral meniscus surgery or total knee arthroplasty. Two subgroup analyses were conducted. Opioid-naive patients with and without an ADD were compared based on the proportion of patients prescribed an opioid within 1 year of APM. Rates of revision meniscus surgery on the ipsilateral knee were also compared within 2 years of APM.

Results: Within 90 days, patients with a pre-existing ADD (n = 26,507), compared to those without (n = 26,507), had higher rates of health care utilization, including readmission (P < .001), and medical complications, like cerebrovascular accident (P = .002). A greater proportion of patients with an ADD were prescribed opioids at all chosen time points within 1 year of APM. Similarly, a greater proportion of opioid-naive patients with an ADD were prescribed opioids within 6 months (P < .001) and 1 year (P < .001). Patients with an ADD also had higher rates of total knee arthroplasty (P = .001) and ipsilateral revision meniscus surgery (left knee: P = .020; right knee: P = .019) within 2 years.

Conclusions: Patients with an anxiety or depressive disorder have higher rates of health care utilization, medical complications, opioid prescriptions, and subsequent knee surgery after isolated primary arthroscopic partial meniscectomy.

Level of evidence: Level III, retrospective cohort study.