New-onset anxiety and depression after anterior cruciate ligament reconstruction: A national database study of incidence, risk-factors, and outcomes

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-05-21 DOI:10.1016/j.knee.2025.05.005

Andrea H. Johnson, David C. Lutati, Jacob Z. Offer, Jane C. Brennan, Benjamin M. Petre, James J. York, Daniel E. Redziniak, Justin J. Turcotte

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引用次数: 0

Abstract

Background

Prior studies evaluating the mental-health burden of recovery from anterior cruciate ligament reconstruction (ACLR) have focused primarily on athletes. The purpose of this study is to evaluate rates of new-onset anxiety and depression (NOAD) after ACLR and identify risk factors in the broad population of ACLR patients.

Methods

A retrospective review of the PearlDiver national database was performed. All patients included had no prior diagnosis of depression or anxiety prior to undergoing ACLR and had ≥1-year follow-up. The primary outcome was development of NOAD within 1-year postoperatively. Multivariate regression was used to assess predictors of NOAD; clinical outcomes were compared between patients with and without NOAD.

Results

Of the 20,442 ACLR patients included, 1,284 (6.3%) were diagnosed with NOAD within 1-year postoperatively. Men (OR: 0.63, p < 0.001) and patients from the southern US (OR: 0.81, p = 0.007) had lower rates of NOAD. Conversely, older patients (OR: 1.02, p < 0.001), patients with alcohol disorders (OR: 2.19, p < 0.001), anemia (OR: 1.26, p = 0.008), headaches/migraines (OR: 1.60, p < 0.001), obesity (OR: 1.38; p < 0.001), sleep apnea (OR: 1.40, p < 0.001), tobacco use (OR: 2.15, p < 0.001), and preoperative opioid use (OR: 1.23, p = 0.001) had higher rates of NOAD. Postoperatively, patients with NOAD had higher rates of 90-day readmission (1.1% vs. 0.3%; p < 0.001), higher rates of opioid use at 1-year (30.7% vs. 20.4%; p < 0.001), and higher rates of additional knee surgery at 2-years (5.4% vs. 3.2%; p < 0.001).

Conclusion

The current study highlights risk factors for NOAD after ACLR that may be used to identify at-risk populations. The development of targeted multidisciplinary interventions may improve outcomes for these patients.

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前交叉韧带重建后新发焦虑和抑郁：发生率、危险因素和结果的国家数据库研究

背景先前评估前交叉韧带重建（ACLR）后恢复的心理健康负担的研究主要集中在运动员身上。本研究的目的是评估ACLR术后新发焦虑和抑郁（NOAD）的发生率，并确定ACLR患者中广泛人群的危险因素。方法回顾性分析PearlDiver国家数据库。所有纳入的患者在行ACLR前均无抑郁或焦虑诊断，随访≥1年。主要观察指标为术后1年内NOAD的发生情况。采用多元回归评估NOAD的预测因素；比较NOAD患者和非NOAD患者的临床结果。结果纳入的20442例ACLR患者中，1284例（6.3%）在术后1年内被诊断为NOAD。男性(OR: 0.63, p <；0.001)，来自美国南部的患者（OR: 0.81, p = 0.007） NOAD的发生率较低。相反，老年患者(OR: 1.02, p <；0.001)，酒精障碍患者(OR: 2.19, p <；0.001)，贫血（OR: 1.26, p = 0.008），头痛/偏头痛(OR: 1.60, p <；0.001)，肥胖(OR: 1.38；p & lt;0.001)，睡眠呼吸暂停(OR: 1.40, p <；0.001)，烟草使用(OR: 2.15, p <；0.001)，术前使用阿片类药物（OR: 1.23, p = 0.001）的NOAD发生率较高。术后NOAD患者90天再入院率较高(1.1% vs. 0.3%；p & lt;0.001)， 1年内阿片类药物使用率较高(30.7% vs. 20.4%；p & lt;0.001)， 2年内额外膝关节手术的比例更高(5.4% vs. 3.2%；p & lt;0.001)。结论本研究突出了ACLR术后NOAD的危险因素，可用于识别高危人群。有针对性的多学科干预措施的发展可能会改善这些患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.