Abstract
Objectives:
Psychiatric disorders such as depression and anxiety have a high prevalence, but these conditions often go unrecognized in the orthopaedic setting. Existing research has shown the impact of psychiatric conditions on functional outcomes in a variety of orthopaedic procedures, but data on the effects of these diagnoses on outcomes after meniscectomy are limited. We sought to evaluate the influence of comorbid anxiety and depression on pain and functional outcomes following meniscectomy.
Methods:
Between 2016 and 2018, 141 patients scheduled for arthroscopic meniscectomy consented to participate. Preoperatively, patients completed the Computerized Adaptive Testing-Mental Health (CAT-MH) questionnaire, which screened for the presence or absence of major depressive disorder and the dimensional severity of anxiety and mania. Functional outcome measures collected preoperatively and at six months postoperatively included IKDC, KOOS, SF-12, VR12, and VR6D. We compared relevant outcomes between MDD positive and MDD negative individuals, and correlated symptoms of anxiety and mania to outcome scores.
Results:
120 patients completed the study. Seventy (58.3%) were male, and 50 were female (41.7%). Thirteen patients (10.9%) screened positive for major depressive disorder (MDD), ten (76.9%) of whom were female. MDD-positive patients reported lower scores on all outcomes pre-operatively and six months post-operatively. Higher anxiety levels were also associated with lower baseline and postoperative scores. Both MDD-positive and negative cohorts showed significant improvements in most outcome measures post-operatively. We found no differences in the absolute improvements between both groups.
Conclusions:
Comorbid anxiety and depression are associated with worse functional outcomes preoperatively and at 6 months follow-up after meniscectomy. However, the degree of improvement in functional scores at 6 months is similar regardless of psychiatric conditions. Our findings suggest that factors such as psychiatric comorbidities and gender independently impact commonly used functional outcome scores. This emphasizes the importance of mental health screening in optimizing functional outcomes in orthopaedics.
