PMS70 PSYCHOLOGICAL SYMPTOMS AND TOTAL KNEE REPLACEMENT.

Abstract

Psychological aspects are important when considering total knee replacement (TKR). The objective was to evaluate changes from baseline to 6-months post-surgery in anxiety and depression in patients who have undergone TKR according to OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) responder criteria to the intervention. This was a prospective cohort study of patients with osteoarthritis who have undergone TKR. While on the waiting list and 6-monts post-surgery, patients fulfilled several questionnaires: Hospital Anxiety and Depression Scale (HADS-a and HADS-d), WOMAC questionnaire and questions about patient global assessment of disease. OMERACT-OARSI responder criteria were based on a combination of absolute and relative change of WOMAC pain and function, and global patient’s assessment. HADS-a and HADS-d baseline and change scores were compared among responders and non-responders by the Wilcoxon test. 278 patients fulfilled baseline and 6-monts pot-surgery questionnaires. There were 40 (14.4%) patients classified as non-responders. At baseline, the mean (SD) scores were 6.6 (4.3) and 8.1 (5.1) for HADS-a (p=0.08) and 5.9 (3.5) and 7.1 (4.4) for HADS-d (p=0.09) in non-responders and responders, respectively. Regarding changes in HADS-a at 6-months, the non-responders experienced a worsening of -1.4 (SD, 4.4) points while responders had an improvement of 3.2 (SD, 4.9) points (p < 0.001). Changes at 6-months in HADS-d were also a worsening of - 1.3 (SD, 4.4) among non-responders, and an improvement of 2.6 (SD, 4.4) among responders (p < 0.001). :In patients undergoing TKR, psychological aspects get worse when the outcome measured by responder criteria based on changes in pain, function and global assessment is not met. Greater attention should be placed to mental health in these patients.