Abstract：
OBJECTIVE: This study aimed to investigate how psychological factors, including pain catastrophizing (PC), anxiety and depression affect preoperative and postoperative subjective outcomes in patients undergoing unicompartmental knee arthroplasty (UKA).
METHODS: A prospective comparative study was performed among 150 patients undergoing medial or lateral UKA for isolated unicompartmental osteoarthritis. Patients were categorized based on their preoperative PC and Hospital Anxiety and Depression Scale, stratifying them into groups with PC, anxiety or depression, and those without these psychological factors. Patient-reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score-Physical function Short form (KOOS-PS), 5-level EQ5D Visual Analogue Scale (EQ5D-VAS), Forgotten Joint Score (FJS) and Numeric Rating Scale for pain (NRS-pain) were compared between groups preoperatively and at 6-, 12-, and 24-month follow-up.
RESULTS: At 24 months, PC patients had inferior outcomes in KOOS-PS (66.9 ± 16.5 vs. 77.6 ± 14.7, p = .008), EQ5D-VAS (63.5 ± 19.9 vs. 78.9 ± 20.1, p = .003) and FJS (73.7 ± 14.3 vs. 84.6 ± 13.8, p = .003). Anxiety was associated with inferior KOOS-PS (65.4 ± 15.2 vs. 78.2 ± 14.5, p = <.001), EQ5D-VAS (64.2 ± 23.2 vs. 79.3 ± 19.4, p = .002), FJS (75.7 ± 16.8 vs. 84.6 ± 13.4, p = .008) and NRS-pain (27.4 ± 24.6 vs. 13.7 ± 19.3, p = .023) at 24 months. Depression consistently resulted in inferior outcomes in KOOS-PS, EQ5D-VAS, FJS and NRS-pain across all follow-up assessments (p = <.05). Additionally, patients with anxiety and depression experienced longer length of hospital stay compared to those without these psychological factors (anxiety: 2.3 ± 2.3 vs. 0.8 ± 0.8 days, p = .006; depression: 2.3 ± 2.4 vs. 0.8 ± 0.8 days, p = .017).
CONCLUSIONS: Preoperative PC, anxiety and depression are associated with inferior subjective outcomes both prior to and following UKA. Among these factors, depression seemed to exert the most substantial adverse impact on outcomes following UKA. Patients with anxiety and depression had an extended duration of hospitalization lasting over twice as long as patients without these psychological factors. It seems that inferior outcomes primarily stem from the suboptimal preoperative condition rather than an inherent inability to benefit from UKA.
METHODS: Level II, prospective study.
METHODS: A prospective comparative study was performed among 150 patients undergoing medial or lateral UKA for isolated unicompartmental osteoarthritis. Patients were categorized based on their preoperative PC and Hospital Anxiety and Depression Scale, stratifying them into groups with PC, anxiety or depression, and those without these psychological factors. Patient-reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score-Physical function Short form (KOOS-PS), 5-level EQ5D Visual Analogue Scale (EQ5D-VAS), Forgotten Joint Score (FJS) and Numeric Rating Scale for pain (NRS-pain) were compared between groups preoperatively and at 6-, 12-, and 24-month follow-up.
RESULTS: At 24 months, PC patients had inferior outcomes in KOOS-PS (66.9 ± 16.5 vs. 77.6 ± 14.7, p = .008), EQ5D-VAS (63.5 ± 19.9 vs. 78.9 ± 20.1, p = .003) and FJS (73.7 ± 14.3 vs. 84.6 ± 13.8, p = .003). Anxiety was associated with inferior KOOS-PS (65.4 ± 15.2 vs. 78.2 ± 14.5, p = <.001), EQ5D-VAS (64.2 ± 23.2 vs. 79.3 ± 19.4, p = .002), FJS (75.7 ± 16.8 vs. 84.6 ± 13.4, p = .008) and NRS-pain (27.4 ± 24.6 vs. 13.7 ± 19.3, p = .023) at 24 months. Depression consistently resulted in inferior outcomes in KOOS-PS, EQ5D-VAS, FJS and NRS-pain across all follow-up assessments (p = <.05). Additionally, patients with anxiety and depression experienced longer length of hospital stay compared to those without these psychological factors (anxiety: 2.3 ± 2.3 vs. 0.8 ± 0.8 days, p = .006; depression: 2.3 ± 2.4 vs. 0.8 ± 0.8 days, p = .017).
CONCLUSIONS: Preoperative PC, anxiety and depression are associated with inferior subjective outcomes both prior to and following UKA. Among these factors, depression seemed to exert the most substantial adverse impact on outcomes following UKA. Patients with anxiety and depression had an extended duration of hospitalization lasting over twice as long as patients without these psychological factors. It seems that inferior outcomes primarily stem from the suboptimal preoperative condition rather than an inherent inability to benefit from UKA.
METHODS: Level II, prospective study.
摘要：
目的：本研究旨在探讨心理因素，包括痛苦灾难（PC），焦虑和抑郁影响单室膝关节置换术（UKA）患者术前和术后的主观结局。
方法：对150例接受内侧或外侧UKA治疗的单室骨关节炎患者进行了一项前瞻性比较研究。根据患者的术前PC和医院焦虑和抑郁量表对患者进行分类。用个人电脑将它们分成几组，焦虑或抑郁,以及那些没有这些心理因素的人。患者报告的结果，包括膝关节损伤和骨关节炎结果评分-身体功能简表(KOOS-PS)，5级EQ5D视觉模拟评分（EQ5D-VAS），术前和6-比较两组之间的遗忘关节评分（FJS）和疼痛数字评定量表（NRS-pain）。12-，24个月随访。
结果：在24个月时，PC患者在KOOS-PS中的预后较差（66.9±16.5vs.77.6±14.7，p=.008），EQ5D-VAS(63.5±19.9vs.78.9±20.1，p=.003）和FJS（73.7±14.3与84.6±13.8，p=.003）。焦虑与低KOOS-PS（65.4±15.2vs.78.2±14.5，p=<.001)，EQ5D-VAS(64.2±23.2vs.79.3±19.4，p=.002），FJS（75.7±16.8vs.84.6±13.4，p=.008）和NRS疼痛（27.4±24.6vs.13.7±19.3，p=0.023），24个月。抑郁症持续导致KOOS-PS较差的结果，EQ5D-VAS,所有随访评估中的FJS和NRS疼痛(p=<.05)。此外,与没有这些心理因素的患者相比，焦虑和抑郁症患者的住院时间更长（焦虑：2.3±2.3vs.0.8±0.8天,p=.006；抑郁：2.3±2.4vs.0.8±0.8天,p=.017）。
结论：术前PC，在UKA之前和之后，焦虑和抑郁与较差的主观结果相关。在这些因素中,抑郁症似乎对UKA术后结局产生了最显著的不利影响.焦虑和抑郁症患者的住院时间延长，持续时间是没有这些心理因素的患者的两倍。似乎较差的结果主要是由于术前状况欠佳，而不是固有的无法从UKA中受益。
方法：二级，前瞻性研究。
方法：对150例接受内侧或外侧UKA治疗的单室骨关节炎患者进行了一项前瞻性比较研究。根据患者的术前PC和医院焦虑和抑郁量表对患者进行分类。用个人电脑将它们分成几组，焦虑或抑郁,以及那些没有这些心理因素的人。患者报告的结果，包括膝关节损伤和骨关节炎结果评分-身体功能简表(KOOS-PS)，5级EQ5D视觉模拟评分（EQ5D-VAS），术前和6-比较两组之间的遗忘关节评分（FJS）和疼痛数字评定量表（NRS-pain）。12-，24个月随访。
结果：在24个月时，PC患者在KOOS-PS中的预后较差（66.9±16.5vs.77.6±14.7，p=.008），EQ5D-VAS(63.5±19.9vs.78.9±20.1，p=.003）和FJS（73.7±14.3与84.6±13.8，p=.003）。焦虑与低KOOS-PS（65.4±15.2vs.78.2±14.5，p=<.001)，EQ5D-VAS(64.2±23.2vs.79.3±19.4，p=.002），FJS（75.7±16.8vs.84.6±13.4，p=.008）和NRS疼痛（27.4±24.6vs.13.7±19.3，p=0.023），24个月。抑郁症持续导致KOOS-PS较差的结果，EQ5D-VAS,所有随访评估中的FJS和NRS疼痛(p=<.05)。此外,与没有这些心理因素的患者相比，焦虑和抑郁症患者的住院时间更长（焦虑：2.3±2.3vs.0.8±0.8天,p=.006；抑郁：2.3±2.4vs.0.8±0.8天,p=.017）。
结论：术前PC，在UKA之前和之后，焦虑和抑郁与较差的主观结果相关。在这些因素中,抑郁症似乎对UKA术后结局产生了最显著的不利影响.焦虑和抑郁症患者的住院时间延长，持续时间是没有这些心理因素的患者的两倍。似乎较差的结果主要是由于术前状况欠佳，而不是固有的无法从UKA中受益。
方法：二级，前瞻性研究。
