ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Anxiety and depression prior to total knee arthroplasty are associated with worse pain and subjective function: A prospective comparative study.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Are preoperative psychological factors associated with chronic postoperative pain after total knee arthroplasty: a systematic review.EFORT open reviews · 2026Pooled it
- Pharmacologic pain management strategies for reducing postoperative pain in total knee arthroplasty: a systematic review from molecular mechanisms to clinical efficiency.Archives of orthopaedic and trauma surgery · 2025Pooled it
- Article
- Relationship Between Postoperative Pain in Surgery and the Onset of Psychological Symptoms Such as Mental Anxiety and Depression.Actas espanolas de psiquiatria · 2026Article
- Association between pre-operative mental health and recovery outcomes following total knee arthroplasty.Scientific reports · 2026Article
- Genicular Artery Embolization Using Resorbable Gelatin Microspheres for Refractory Knee Pain: Technique, Safety and Clinical Outcome.Cardiovascular and interventional radiology · 2026Observational
- Objective functional performance 1 year after total knee arthroplasty does not differ for patients with symptoms of anxiety, depression or pain catastrophizing: A prospective study of 289 patients.Journal of experimental orthopaedics · 2026Article
- Early Postoperative Pain and Its Risk Factors in Patients Undergoing Total Knee Arthroplasty Under the ERAS Protocol.Journal of pain research · 2026Article
- Anxiety and depression in non-cardiac surgical patients and associations with adverse outcomes: A systematic review and meta-analysis.Journal of anesthesia and translational medicine · 2025Review
- Are Currently Available Joint-Specific Patient-Reported Outcome Measures Fit for Purpose to Assess the Outcome of Knee Arthroplasty?Journal of clinical medicine · 2025Article
- Depressive symptoms influence progression to total knee arthroplasty in patients with early knee osteoarthritis: Evidence from the Osteoarthritis Initiative database.Journal of experimental orthopaedics · 2025Article
- The impact of nursing-led emotional preparation on mental health after total hip arthroplasty.Frontiers in psychology · 2025Article
- Applying the Knowledge-to-Action Framework to Implement and Evaluate an Evidence-Based Functional Exercise Program for Elderly Patients After Total Knee Arthroplasty: A Mixed-Methods Study.Clinical interventions in aging · 2025Article
- Anxiety and depression prior to total knee arthroplasty are associated with worse pain and subjective function: A prospective comparative study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity-score matched study.Journal of experimental orthopaedics · 2025Article
- Same patient but different worlds: A state-of-the-art review translating best practice psychosocial care from musculoskeletal care to the orthopaedic context.BMC musculoskeletal disorders · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
purposeThe aim of this study was to investigate the influence of preoperative anxiety and depression on subjective function, pain and revision rates following total knee arthroplasty (TKA).
methodsA prospective comparative study was conducted, including 349 patients undergoing TKA surgery between January 2019 and April 2021. Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively, and a set of Patient-Reported Outcome Measures (PROMs) preoperatively and at 6, 12 and 24 months postoperatively. Patients were categorized into anxiety and depression groups based on HADS scores. PROMs included the Knee injury and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), Oxford Knee Score (OKS) and NRS-Pain. Differences in PROM scores between the anxiety/depression group and, respectively, nonanxiety/nondepression group were assessed, as well as differences in minimal clinical important difference (MCID) and attainment of Patient Acceptable Symptom State (PASS). Lastly, revision rates were compared.
resultsAnxiety and depression groups exhibited inferior subjective function preoperatively and postoperatively compared to nonanxiety and nondepression groups (all p < 0.05), experienced more pain preoperatively (p < 0.001) and also postoperatively for depression patients (all p < 0.05). Significantly fewer patients with anxiety and depression reached the PASS for KOOS-PS, OKS and NRS-Pain (all p < 0.05). There were no differences in the proportion of patients reaching the MCID for all PROMs (all p > 0.060), and revision rates did not differ between groups (both p > 0.96).
conclusionPreoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2-year follow-up in patients undergoing TKA. Revision rates did not differ between groups, and there were no relevant differences in clinical improvement of subjective function and pain. LEVEL OF EVIDENCE: Level II, prospective comparative study.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.