The relationship between mental health/physical activity and pain/dysfunction in working-age patients with knee osteoarthritis being considered for total knee arthroplasty: a retrospective study

BACKGROUND: Increasing total knee arthroplasty (TKA) surgeries are being performed on working-age patients with prominent manifestations of pain and dysfunction. But few studies have explored the risk factors for pain and dysfunction in working-age patients with knee osteoarthritis (KOA) being considered for TKA. Therefore, this study sought to explore the relationship between mental health/physical activity and pain/dysfunction in working-age patients with KOA being considered for TKA. METHODS: This study was a secondary analysis of data derived from a public database, the Work participation In Patients with Osteoarthritis cohort study, which included 152 working-age patients (65 men and 87 women) with KOA planning for TKA. We analyzed preoperative data comprising age, educational level, body mass index (BMI), mental factors (Patient Health Questionnaire-9 [PHQ-9] and the 36-Item Short Form Survey Instrument [SF-36 mental health]), physical activity level, and clinical outcomes (the Western Ontario and McMaster Universities Osteoarthritis Index and SF-36 sub-item score). Multivariate regression analysis was performed to determine risk factors for pain and dysfunction in working-age patients with KOA being considered for TKA. RESULTS: Women had lower pain, worse function, and higher PHQ-9 scores than men (p < 0.001). The depression scores were significantly linearly related to pain and function scores in women after adjusting for age, BMI, educational level, and physical activity (P < 0.05), whereas this relation was not observed in men. After adjusting for age, BMI, educational level, and mental factors, exercise time was found to be positively correlated with pain scores in women (P < 0.05). CONCLUSIONS: Depression scores and exercise time were significantly correlated with pain and dysfunction in working-age women with KOA being considered for TKA.