Preoperative anxiety and depression are associated with poorer patient-reported outcomes following total ankle replacements.

Foot Ankle Surg

Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, United Kingdom.

Published: January 2025

Introduction: It is unclear how pre-operative anxiety/depression affects patient reported outcome measures (PROMs) following total ankle replacements (TAR). We investigated the effects of anxiety/depression on PROMs using the Manchester-Oxford Foot Questionnaire (MOXFQ) following TAR.

Methods: PROMs data for primary TAR patients between 2011 and 2022 were extracted from a single-centre regional registry. Anxiety/depression was self-reported using the EuroQol 5-deminion (EQ-5D-3L) questionnaire. MOXFQ was applied pre-operatively and ≥ 6-months post-operatively.

Results: We included 98 TARs with mean follow-up of 2.1 ± 2.0 years. 35(35.7 %) patients reported anxiety/depression pre-operatively. Significant difference between pre-operative MOXFQ-index for the anxiety/depression group (83.8 ± 12.9) and the control group (71.8 ± 12.7, p < 0.001) persisted post-operatively (40.8 ± 30.1, 25.7 ± 24.6, p = 0.008). Both groups experienced significant improvement in MOXFQ-index post-operatively (p < 0.001). Overall improvement was similar between groups after adjustment for confounders (p = 0.42).

Conclusion: PROMs are modulated by baseline mental health after TAR. However, both groups report similar post-operative improvement.

Level Of Evidence: Level III Retrospective Cohort Study.

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http://dx.doi.org/10.1016/j.fas.2025.01.006DOI Listing

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