The impact of total knee arthroplasty on functional outcomes and mental health: A prospective study

Purpose

Knee osteoarthritis (OA) is a leading cause of disability and chronic pain; total knee arthroplasty (TKA) is the effective treatment in the end stages of knee OA after failure of conservative management. This study has focused on the effects of primary TKA on knee function, levels of depression, and anxiety.

Methods

The study population is a cohort of 100 patients who underwent primary TKA in a tertiary center in Jordan. Oxford Knee Score (OKS), Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 score assessments were performed preoperatively and three months postoperatively.

Results

The results showed a dramatic improvement in knee function, with the mean OKS increasing from 17.9 preoperatively to 38.4 postoperatively (p < 0.001). Moreover, the percentage of patients who reported no or mild depression increased from 62% to 91%, and those who reported minimal or mild anxiety also increased from 76% to 95%. A multivariate linear regression showed that age, osteoporosis, and smoking were independently associated with the anxiety and depression score changes. These represent not only pain improvement but also a dual benefit in the field of mental health following TKA.

Conclusion

Primary TKA showed significant improvement in patients' depression and anxiety, along with the improvement of their knee functional scores. Discussing psychological factors with patients preoperatively might be important along with the functional outcome in making the surgical decision.

Level of Evidence

Level II, prospective cohort study.