The impact of depression, personality and mental health on early outcomes of Total Knee Arthroplasty

BackhroundsIncreasing more attention to mental health and psychological determinants, may beuseful in identifying patients at risk for poor postoperative outcomes of Total KneeArthroplasty (TKA). The aim of this study was to investigate the influence of depression,personality and physical and mental health in early outcomes of patients undergoingTKA.Methods54 patients undergoing unilateral TKA were assessed preoperatively with OxfordHappiness Inventory (OHI), Eysenck Personality Inventory (EPI), -12Item Short FormHealth Survey (SF12-) and Knee Injury and Osteoarthritis Outcome Score (KOOS) forevaluating depression, personality traits, physical and mental health and function,respectively. Six months after surgery, Health-Related Quality of Life (HRQL) andfunction were assessed using SF12- and KOOS.Results HRQL and function of all personality traits increased significantly after TKA,without significant difference between them. Extroversion and neuroticism did nothave significant correlation with subjective well-being, HRQL and function before andafter surgery. Subjective well-being and baseline physical and mental health scoreswere correlated strongly and directly with postoperative Physical Component Summary(PCS), Mental Component Summary (MCS), KOOS scores and their improvement.Among many factors that significantly affect early outcomes of TKA, the onlyindependent predictor of physical, mental and functional outcome was depression.Conclusions Outcomes of surgery were not significantly different between diversepersonality traits. Patients with less depressive symptoms and higher baseline mentaland physical scores had significant greater improvement in HRQL after surgery. Theonly independent factor affecting the physical, mental and functional outcome wasdepression.