Changes in mental health and joint-specific patient-reported outcome measures following arthroscopic shoulder labral repair

Abstract

Background

The purpose was to identify the effects of mental health on postoperative outcomes following arthroscopic labral repair. It was hypothesized that low preoperative mental health, measured by the Veterans RAND 12-Item Health Survey Mental Component Score (VR-12 MCS), would demonstrate inferior patient-reported outcome measures preoperatively and postoperatively, but that improvement would be similar.

Methods

Fifty subjects undergoing a primary arthroscopic anterior labral repair were included. Subjects completed the VR-12 MCS, Pain Visual Analog Scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) at 4 timepoints. Subjects with a VR-12 MCS score below 42.9 were classified to a low MCS cohort and those with a VR-12 MCS score above 42.9 were cataloged to a high MCS group. Patient-reported outcome measures were compared between the 2 groups.

Results

At mean follow-up of 18.7 months, ASES (P < .001), VAS (low MCS P = .004; high MCS P < .001), and SANE (P < .001) scores significantly improved for both cohorts. The low MCS group had significantly lower ASES scores at both points (P = .01); however, the preoperative to postoperative change in ASES (P = .32) did not differ. VR-12 MCS scores remained constant in the high MCS cohort but significantly improved for the low MCS cohort (P = .01).

Conclusion

Patients in the low VR-12 MCS group had lower postoperative outcomes but demonstrated similar preoperative to postoperative improvements in ASES, SANE, and VAS to those in the high group. VR-12 MCS significantly improved for the low MCS group suggesting that low preoperative mental health scores should not be considered a contraindication for surgery and mental health scores are modifiable.