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Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery
PURPOSE: This study was designed to evaluate predictive factors that influence pain, mental health symptoms and postoperative outcomes at six-months post-hip preservation surgery (HPS) in adolescent surgical candidates. METHODS: In total, 58 HPS candidates (39 female, 19 male; mean age 15.53 years (...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453166/ https://www.ncbi.nlm.nih.gov/pubmed/32874357 http://dx.doi.org/10.1302/1863-2548.14.200013 |
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author | Richard, Heather M. Cerza, Shelby P. De La Rocha, Adriana Podeszwa, David A. |
author_facet | Richard, Heather M. Cerza, Shelby P. De La Rocha, Adriana Podeszwa, David A. |
author_sort | Richard, Heather M. |
collection | PubMed |
description | PURPOSE: This study was designed to evaluate predictive factors that influence pain, mental health symptoms and postoperative outcomes at six-months post-hip preservation surgery (HPS) in adolescent surgical candidates. METHODS: In total, 58 HPS candidates (39 female, 19 male; mean age 15.53 years (10 to 19)) were evaluated. Diagnoses included: acetabular dysplasia (34); idiopathic femoroacetabular impingement (15); Perthes disease (six); avascular necrosis (six); and slipped capital femoral epiphysis (six). All patients underwent periacetabular osteotomy (36), surgical hip dislocation (17) or arthroscopy (five). Patients completed the following: Numerical Pain Rating Scale (NPRS); Child Health Questionnaire-87 (CHQ-87); Pediatric Symptom Checklist-Youth (PSC-Y), preoperatively and six months postoperatively. A single psychologist assessed patients in clinics and one to two additional appointments. RESULTS: In all, 78% of patients reported one to three years of pain prior to HPS (modified Harris hip score). All pain scores (NPRS) significantly decreased at six months postoperatively. Preoperative mental health scores (CHQ-87) significantly predicted postoperative pain scores (F(1, 57) = 4.07; p < 0.048; R2 = 0.068). Mental health symptoms (PSC-Y) decreased significantly (p < 0.001). Patients who were seen by a psychologist two or more times reported better six-month postoperative outcomes than those seen once: usual pain (NPRS; p = 0.012); patient-reported physical function (CHQ-87; p = 0.029); and mental health (PSC-Y; p = 0.019). HPS patients seen ≥ 60 days prior to surgery showed marked improvements at six months compared with patients seen < 60 days prior to surgery. CONCLUSION: HPS candidates evaluated preoperatively by psychology, as part of an integrated treatment approach, demonstrated statistically significant improvements in pain, health-related quality of life and mental health symptoms. Two+ visits, more than 60 days prior to surgery appears to be impactful. Preoperative pain and mental health symptoms were predictive of postoperative pain. Level of Evidence: II |
format | Online Article Text |
id | pubmed-7453166 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-74531662020-08-31 Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery Richard, Heather M. Cerza, Shelby P. De La Rocha, Adriana Podeszwa, David A. J Child Orthop Original Clinical Article PURPOSE: This study was designed to evaluate predictive factors that influence pain, mental health symptoms and postoperative outcomes at six-months post-hip preservation surgery (HPS) in adolescent surgical candidates. METHODS: In total, 58 HPS candidates (39 female, 19 male; mean age 15.53 years (10 to 19)) were evaluated. Diagnoses included: acetabular dysplasia (34); idiopathic femoroacetabular impingement (15); Perthes disease (six); avascular necrosis (six); and slipped capital femoral epiphysis (six). All patients underwent periacetabular osteotomy (36), surgical hip dislocation (17) or arthroscopy (five). Patients completed the following: Numerical Pain Rating Scale (NPRS); Child Health Questionnaire-87 (CHQ-87); Pediatric Symptom Checklist-Youth (PSC-Y), preoperatively and six months postoperatively. A single psychologist assessed patients in clinics and one to two additional appointments. RESULTS: In all, 78% of patients reported one to three years of pain prior to HPS (modified Harris hip score). All pain scores (NPRS) significantly decreased at six months postoperatively. Preoperative mental health scores (CHQ-87) significantly predicted postoperative pain scores (F(1, 57) = 4.07; p < 0.048; R2 = 0.068). Mental health symptoms (PSC-Y) decreased significantly (p < 0.001). Patients who were seen by a psychologist two or more times reported better six-month postoperative outcomes than those seen once: usual pain (NPRS; p = 0.012); patient-reported physical function (CHQ-87; p = 0.029); and mental health (PSC-Y; p = 0.019). HPS patients seen ≥ 60 days prior to surgery showed marked improvements at six months compared with patients seen < 60 days prior to surgery. CONCLUSION: HPS candidates evaluated preoperatively by psychology, as part of an integrated treatment approach, demonstrated statistically significant improvements in pain, health-related quality of life and mental health symptoms. Two+ visits, more than 60 days prior to surgery appears to be impactful. Preoperative pain and mental health symptoms were predictive of postoperative pain. Level of Evidence: II The British Editorial Society of Bone & Joint Surgery 2020-08-01 /pmc/articles/PMC7453166/ /pubmed/32874357 http://dx.doi.org/10.1302/1863-2548.14.200013 Text en Copyright © 2020, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Original Clinical Article Richard, Heather M. Cerza, Shelby P. De La Rocha, Adriana Podeszwa, David A. Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
title | Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
title_full | Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
title_fullStr | Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
title_full_unstemmed | Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
title_short | Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
title_sort | preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453166/ https://www.ncbi.nlm.nih.gov/pubmed/32874357 http://dx.doi.org/10.1302/1863-2548.14.200013 |
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