Outcomes after primary reverse total shoulder arthroplasty in patients with comorbid anxiety and depressive disorders: a retrospective cohort study

Abstract

Background: Current literature generally indicates that anxiety and depressive disorders have negative effects on the outcomes of orthopaedic procedures. We studied a patient population with primary reverse total shoulder arthroplasty (RTSA) to evaluate the effect of these disorders on 2-year outcomes. Methods: Patients were classified as having depression or anxiety by documentation of such in the chart or the use of a prescription mood-stabilizing drug. Pain and function were evaluated with visual analog scale (VAS) and American Shoulder and Elbow Surgeons (ASES) scores, respectively. Data for complications, reoperations, and readmissions were also compiled, and radiographs were assessed for loosening or component failure at the most recent follow-up. Results: Database search identified 112 patients (114 shoulders) with primary RTSA and a minimum of 2-year clinical and radiographic follow-up. Thirty-one patients were categorized as having depression and/or anxiety, and 81 (83 shoulders) did not have these disorders. Significantly more women than men were in the anxiety and depression group (P=0.007). There were no significant differences in other patient demographics or VAS, ASES score, range of motion, or strength at 2-year follow-up (all P>0.05). Three complications occurred in the anxiety/depression group, and 16 occurred in the group without these disorders (P=0.34). Conclusions: Contrary to most current literature, these results suggest that patients with anxiety and/or depression can expect similar outcomes as those of patients without these disorders after primary RTSA. Level of Evidence: Level III.