Investigation of relationship between preoperative anxiety and depression and postoperative functional performance

Objective: Knee Arthroplasty is being increasingly performed, more often in patients with severe knee Osteoarthritis (OA). Twenty percent of patients remain dissatisfied after Total Knee Arthroplasty (TKA), despite the apparent technical success of the operation. The suboptimal results of TKA in terms of patients reported outcome surveys in subgroups of patients cannot be entirely explained by patients' physical characteristics, adverse events, physical co-morbidities or surgery itself, but seem to be related to other characteristics, including psychological symptoms. Psychological distress has been associated with lower scores after TKA. Recently, numerous studies have reported that psychological factors can influence the outcome of TKA. However there is no study that used objective measurement such as time based functional measurement. The aim of the current study was to investigate of relationship between preoperative anxiety and depression and objective outcome measurement tools. Method: This study was carried out on 45 patients who have undergoing TKA. Assessments were performed at preoperatively and 3 months after surgery. Outcomes measurement tools were the Hospital for Special Surgery, 50 foot walking test 30- second chair stand test and 9 step stair test as time based functional performance, Short Form-12 as a health related quality of life and hospital anxiety and depression scale. All the patients were randomly assigned in two groups for anxiety, depression sub anxiety and sub depression groups. SPSS program version 22.0 mann-u whitney was used for statistical analysis. Results: Preoperative low anxiety group walk in shorter time than high anxiety group in 50-foot walking test (p<0,05). Preoperative low anxiety group walk in shorter time than high anxiety group in 9 step stair test (p<0,05). There are no differences in terms of 30- second chair stand test between groups. Conclusion: Post operation walking and stair climbing performance were affected pre-operative anxiety level in patients with TKA. Keywords: Anxiety and Depression, Timed Performance, Total Knee Arthroplasty.