Editorial Commentary: Clinically Depressed Patients Show Worse Outcomes After Anterior Cruciate Ligament Reconstruction Than Situationally Depressed Patients and Patients Without Mood Issues.

The impact of psychological factors on outcome after orthopaedic surgery is increasingly well reported. Specific to anterior cruciate ligament reconstruction, prior authors have reported that psychological factors influence return-to-sport outcome. Recent research shows that there is a difference between clinical depression and situational depression. Situationally depressed patients score low on psychological screens but do not have a pre-injury clinical diagnosis for depression. Clinically depressed patients score worse on outcome measures after anterior cruciate ligament reconstruction than situationally depressed patients and patients without any mood issues. Furthermore 90.5% of situationally depressed patients had postoperative resolution of their depressive symptoms. Although there appears to be a strong link between clinical depression and limited postoperative outcome, it is still unclear whether depression is a modifier of outcome or whether poor outcome is predictive of persistent depression.