Anxiety and depression are associated with lower preoperative quality of life and function but not duration of symptoms in patients with femoroacetabular impingement syndrome

Abstract

Abstract The purposes of this study were to determine the prevalence of anxiety and depression in patients undergoing primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and to compare duration of symptoms (DOS), hip morphology and self-reported pain and function between patients with and without anxiety or depression. From our Institutional Review Board approved registry, we identified 127 consecutive participants [94F/33M; age = 35.2 ± 12.1 years; body mass index (BMI) = 26.8 ± 5.6 kg/m2] scheduled for primary hip arthroscopy for FAIS. Anxiety and depression were recorded based on medical chart diagnoses or anti-depressive/anti-anxiety prescriptions. Alpha angle, lateral center edge angle and DOS were recorded, and the Hip Disability and Osteoarthritis Outcome Score (HOOS) was completed. Groups were compared using Mann–Whitney U tests, and categorical variables were compared using Fisher’s exact tests. Overall, 45 of 127 participants (35.4%) (94F/33M; age = 35.2 ± 12.1 years; BMI = 26.8 ± 5.6 kg/m2) had anxiety or depression. DOS and bony morphology did not differ between groups (P = 0.11–0.21). Participants with anxiety or depression were older (P = 0.03) and had worse HOOS QOL (21.4 ± 18.4; 30.7 ± 19.6; P = 0.006; 95% CI 2.4–16.3) and HOOS sport (25.6 ± 17.8, 34 ± 21.1, P = 0.03, 95% CI 1.4–15.4). More than one third of participants presented with anxiety or depression. Self-reported quality of life and function were worse for these participants, but neither symptom chronicity nor bony morphology differed. Concomitant anxiety or depression should be considered when counseling patients with FAIS. Adjunct interventions as well genetic and/or developmental factors that may contribute to the high prevalence should be examined.