Ahad A Kesaria, Brady P Moore, Oluwatofe Alimi, William M Weiss
{"title":"诊断出的精神健康障碍与较高的术后并发症发生率、附加手术、前交叉韧带重建后较低的前交叉韧带撕裂和翻修率相关。","authors":"Ahad A Kesaria, Brady P Moore, Oluwatofe Alimi, William M Weiss","doi":"10.1016/j.arthro.2025.05.037","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the influence of diagnosed mental disorders on postoperative outcomes after arthroscopic anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>Using the TriNetX health network database, we evaluated postoperative complications and additional procedures of patients who underwent arthroscopic ACL reconstruction over a 20-year period. Patients with a documented mental health disorder (e.g., anxiety or depression) within 1 year preceding surgery were compared with patients without mental health disorders. The cohorts were propensity-matched for demographic and medical factors, including hypertension, type 2 diabetes, and obesity. Short- and long-term outcomes were evaluated within 90 days and 3 years postoperative, respectively. A χ<sup>2</sup> analysis was performed to compare outcomes between the 2 cohorts.</p><p><strong>Results: </strong>A total of 8,351 patients with diagnosed mental health disorders were propensity-score matched at a 1:1 ratio with 82,127 patients without diagnosed mental health disorders. Within 90 days postoperative, patients with diagnosed mental health disorders demonstrated significantly greater odds of postoperative infection (P = .0042), lower limb mononeuropathy (P = .025), acute postoperative pain (P < .0001), knee stiffness (P < .0001), and any emergency department visit (P <.0001). Within 3 years postoperative, these patients had significantly greater odds of opioid abuse (P = .0015), knee pain (P < .0001), patella fracture (P =.0008), and arthrocentesis/aspiration/injection (P = .0005) but significantly lower odds of ACL tear (P < .0001) and repeat ACL reconstruction (P = .0033).</p><p><strong>Conclusions: </strong>Diagnosed mental health disorders were associated with increased short- and long-term postoperative complications after ACL reconstruction but also demonstrated a potentially protective association with multiple postoperative outcomes, including decreased odds of additional ACL tears and reconstructions.</p><p><strong>Level of evidence: </strong>Level III, retrospective, comparative cohort study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnosed Mental Health Disorders Are Associated With Greater Rates of Postoperative Complications, Additional Procedures, and Lower Anterior Cruciate Ligament Tears and Revision Rates After Anterior Cruciate Ligament Reconstruction.\",\"authors\":\"Ahad A Kesaria, Brady P Moore, Oluwatofe Alimi, William M Weiss\",\"doi\":\"10.1016/j.arthro.2025.05.037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To analyze the influence of diagnosed mental disorders on postoperative outcomes after arthroscopic anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>Using the TriNetX health network database, we evaluated postoperative complications and additional procedures of patients who underwent arthroscopic ACL reconstruction over a 20-year period. Patients with a documented mental health disorder (e.g., anxiety or depression) within 1 year preceding surgery were compared with patients without mental health disorders. The cohorts were propensity-matched for demographic and medical factors, including hypertension, type 2 diabetes, and obesity. Short- and long-term outcomes were evaluated within 90 days and 3 years postoperative, respectively. A χ<sup>2</sup> analysis was performed to compare outcomes between the 2 cohorts.</p><p><strong>Results: </strong>A total of 8,351 patients with diagnosed mental health disorders were propensity-score matched at a 1:1 ratio with 82,127 patients without diagnosed mental health disorders. Within 90 days postoperative, patients with diagnosed mental health disorders demonstrated significantly greater odds of postoperative infection (P = .0042), lower limb mononeuropathy (P = .025), acute postoperative pain (P < .0001), knee stiffness (P < .0001), and any emergency department visit (P <.0001). Within 3 years postoperative, these patients had significantly greater odds of opioid abuse (P = .0015), knee pain (P < .0001), patella fracture (P =.0008), and arthrocentesis/aspiration/injection (P = .0005) but significantly lower odds of ACL tear (P < .0001) and repeat ACL reconstruction (P = .0033).</p><p><strong>Conclusions: </strong>Diagnosed mental health disorders were associated with increased short- and long-term postoperative complications after ACL reconstruction but also demonstrated a potentially protective association with multiple postoperative outcomes, including decreased odds of additional ACL tears and reconstructions.</p><p><strong>Level of evidence: </strong>Level III, retrospective, comparative cohort study.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-06-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2025.05.037\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.05.037","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Diagnosed Mental Health Disorders Are Associated With Greater Rates of Postoperative Complications, Additional Procedures, and Lower Anterior Cruciate Ligament Tears and Revision Rates After Anterior Cruciate Ligament Reconstruction.
Purpose: To analyze the influence of diagnosed mental disorders on postoperative outcomes after arthroscopic anterior cruciate ligament (ACL) reconstruction.
Methods: Using the TriNetX health network database, we evaluated postoperative complications and additional procedures of patients who underwent arthroscopic ACL reconstruction over a 20-year period. Patients with a documented mental health disorder (e.g., anxiety or depression) within 1 year preceding surgery were compared with patients without mental health disorders. The cohorts were propensity-matched for demographic and medical factors, including hypertension, type 2 diabetes, and obesity. Short- and long-term outcomes were evaluated within 90 days and 3 years postoperative, respectively. A χ2 analysis was performed to compare outcomes between the 2 cohorts.
Results: A total of 8,351 patients with diagnosed mental health disorders were propensity-score matched at a 1:1 ratio with 82,127 patients without diagnosed mental health disorders. Within 90 days postoperative, patients with diagnosed mental health disorders demonstrated significantly greater odds of postoperative infection (P = .0042), lower limb mononeuropathy (P = .025), acute postoperative pain (P < .0001), knee stiffness (P < .0001), and any emergency department visit (P <.0001). Within 3 years postoperative, these patients had significantly greater odds of opioid abuse (P = .0015), knee pain (P < .0001), patella fracture (P =.0008), and arthrocentesis/aspiration/injection (P = .0005) but significantly lower odds of ACL tear (P < .0001) and repeat ACL reconstruction (P = .0033).
Conclusions: Diagnosed mental health disorders were associated with increased short- and long-term postoperative complications after ACL reconstruction but also demonstrated a potentially protective association with multiple postoperative outcomes, including decreased odds of additional ACL tears and reconstructions.
Level of evidence: Level III, retrospective, comparative cohort study.
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Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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