Influence of Depressive Symptoms on the Clinical Outcomes of Total Ankle Arthroplasty |
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| Affiliation: | 1. PGY-4 Orthopedic Resident, The University of Tennessee, Chattanooga, TN;2. Assistant Professor and Director of Foot and Ankle Surgery, The University of Tennessee, Chattanooga, TN;3. PGY-6 Orthopedic Fellow, Philadelphia Hand to Shoulder Center, Philadelphia, PA;4. Associate Professor and Program Director, Foot and Ankle Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL;1. Fellowship-Trained Foot and Ankle Surgeon, The CORE Institute, Phoenix, AZ;2. Fellowship-Trained Foot and Ankle Surgeon, Milwaukee Foot and Ankle Specialists, Wauwatosa, WI;3. Attending, Orthopedic Foot and Ankle Center, Worthington, OH;1. Resident Surgery, Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;2. Assistant Professor and Research Coordinator, Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;3. Trauma Surgeon, Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;4. Professor, Department of Anatomy and Neurosciences, Erasmus MC, Rotterdam, The Netherlands;5. Professor, Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;1. Surgeon, Department of Orthopaedics, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China;2. Resident, Nanjing Drum Tower Hospital, Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China;1. Surgeon, Department of Traumatic Orthopedics, the First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China;2. Professor, Department of Traumatic Orthopedics, the First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China |
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| Abstract: | Many studies have reported the relevance of depression on clinical outcomes after knee or hip arthroplasty. However, no study has investigated this relationship in total ankle arthroplasty (TAA). This study aimed to study the relationship between depressive symptoms and clinical outcomes after TAA. This retrospective comparative study investigated 40 patients who underwent TAA for end-stage ankle arthritis. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale and Patient Health Questionnaire-9. Preoperative and postoperative clinical outcomes were compared using the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores by classifying the subjects into depressive and nondepressive groups. The mean follow-up duration was 24.3 ± 7.3 (range 14 to 37) months. There were 13 and 27 subjects in the depressive and nondepressive groups, respectively. There were no significant differences in the baseline characteristics and preoperative VAS and AOFAS scores between them. The postoperative VAS score was significantly higher in the depressive group (3.1 ± 2.4) than in the nondepressive group (1.4 ± 2.3; p < .001). The postoperative AOFAS scores in the depressive and nondepressive groups were 89.3 ± 13.4 and 95.0 ± 8.1, respectively, showing a significantly superior result in the latter group (p < .001). The clinical outcomes after TAA were poorer in the patients with depressive symptoms than in those without. Depressive symptoms are patient-specific factors or independent predictors that show less improvement after TAA. Therefore, clinical considerations of these symptoms are essential before TAA. |
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