Surgical healing beyond the scalpel: exploring the impact of depressive symptoms on functional recovery in total knee arthroplasty patients

BACKGROUND: Numerous recent studies have explored the association between the mental health condition of patients before surgery and the outcomes of total knee arthroplasty. The objective of this study was to determine the prevalence of depressive symptoms among individuals undergoing total knee arthroplasty and to investigate the impact of pre-operative depressive symptoms as a significant and independent predictor on various health-related quality of life measures for patients undergoing knee surgery. MATERIAL AND METHODS: During the period spanning from August 2019 to May 2020, an orthopedic database was established for the purpose of assessing patients' conditions before their surgeries. The data collection process occurred at three distinct intervals: prior to the surgery, as well as at the third and sixth months following the surgical procedure. In this study, we undertook an evaluation of both pre-operative and postoperative depressive symptoms, as well as functional status, utilizing various self-report measures. These measures included the Becks Depression Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Knee Society Clinical Rating System. RESULTS: A total of 150 patients were included in the study. The proportion of patients who were severely distressed decreased from 99% (149) at the baseline assessment to 76% (114) who had mild depression and 24% (36) at borderline at 3-months of follow-up. At 6-month follow-up period, 85% (128) patients were classified as normal, with 15% (22) displaying mild distress levels. CONCLUSIONS: Patients experiencing depression exhibited notable enhancements in various outcome measures. The findings from this study underscore a two-way relationship between mental health and surgical outcomes. Specifically, the surgical intervention yielded significant improvements in mental health status. Conversely, poorer pre-operative mental health status emerged as a predictive factor for comparatively less favorable outcomes stemming from the surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-023-04302-6.