Iglinski-Benjamin Kag C, Xiao Michelle, Safran Marc R, Abrams Geoffrey D
Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA.
Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
Orthop J Sports Med. 2019 Jan 25;7(1):2325967118822451. doi: 10.1177/2325967118822451. eCollection 2019 Jan.
Active patients with musculoskeletal pain are not immune to psychological or psychiatric disease. Observations suggest that patients undergoing hip arthroscopic surgery may have an increased prevalence of comorbid psychiatric conditions.
Patients undergoing hip arthroscopic surgery have an increased prevalence of concomitant psychiatric diagnoses compared with the general population as well as those undergoing anterior cruciate ligament (ACL) reconstruction.
Case-control study; Level of evidence, 3.
A retrospective review of a medical claims database spanning from 2007 to 2016 was utilized to identify patients with a Current Procedural Terminology (CPT) code indicating that they had undergone hip arthroscopic surgery. This group was then dichotomized to those with or without an International Classification of Diseases, 9th Revision (ICD-9) and 10th Revision (ICD-10) diagnosis code indicating a psychological or psychiatric condition at any time before hip arthroscopic surgery or up to 2 years after hip arthrscopic surgery. As a control, ICD-9 and ICD-10 diagnosis codes for psychological or psychiatric conditions were determined in patients without a CPT code for hip arthroscopic surgery (general population) as well as for 2 surgical groups: those undergoing ACL reconstruction and those undergoing shoulder stabilization surgery. Prevalence was determined in all groups and compared using chi-square analysis.
There were 22,676,069 patients in the database, with 2428 undergoing hip arthroscopic surgery. Those undergoing hip arthroscopic surgery had a 3-fold increased prevalence of concomitant psychiatric diagnoses compared with the general population (52% vs 17%, respectively; < .0001). There was a significant difference in the prevalence of psychiatric diagnoses in the hip arthroscopic surgery group between male and female patients (46% vs 56%, respectively; = .0061), with depression and anxiety being the 2 most common comorbid conditions. Those undergoing hip arthroscopic surgery also had a significantly increased prevalence of concomitant psychiatric diagnoses versus those undergoing ACL reconstruction (52% vs 28%, respectively; < .0001) as well as those undergoing shoulder stabilization surgery (52% vs 42%, respectively; < .0001).
Patients undergoing hip arthroscopic surgery had an increased prevalence of comorbid psychiatric conditions compared with the general population as well as those undergoing ACL reconstruction or shoulder stabilization surgery. Depression and anxiety were the most prevalent concomitant psychiatric diagnoses.
患有肌肉骨骼疼痛的活跃患者并非不会患心理或精神疾病。观察表明，接受髋关节镜手术的患者合并精神疾病的患病率可能会增加。
与普通人群以及接受前交叉韧带（ACL）重建的患者相比，接受髋关节镜手术的患者合并精神疾病诊断的患病率更高。
病例对照研究；证据等级，3级。
利用对2007年至2016年医疗理赔数据库的回顾性分析，识别出具有当前操作术语（CPT）代码表明其接受过髋关节镜手术的患者。然后将该组患者分为有或没有国际疾病分类第9版（ICD - 9）和第10版（ICD - 10）诊断代码的两组，这些代码表明在髋关节镜手术前或术后2年内的任何时间患有心理或精神疾病。作为对照，确定没有髋关节镜手术CPT代码的患者（普通人群）以及两个手术组（接受ACL重建的患者和接受肩关节稳定手术的患者）的心理或精神疾病的ICD - 9和ICD - 10诊断代码。确定所有组的患病率，并使用卡方分析进行比较。
数据库中有22676069名患者，其中2428名接受了髋关节镜手术。与普通人群相比，接受髋关节镜手术的患者合并精神疾病诊断的患病率增加了3倍（分别为52%和17%；P <.0001）。髋关节镜手术组中男性和女性患者的精神疾病诊断患病率存在显著差异（分别为46%和56%；P =.0061），抑郁症和焦虑症是两种最常见的合并症。与接受ACL重建的患者相比，接受髋关节镜手术的患者合并精神疾病诊断的患病率也显著增加（分别为52%和28%；P <.0001），与接受肩关节稳定手术的患者相比也是如此（分别为52%和42%；P <.0001）。
与普通人群以及接受ACL重建或肩关节稳定手术的患者相比，接受髋关节镜手术的患者合并精神疾病的患病率更高。抑郁症和焦虑症是最常见的合并精神疾病诊断。
