Longo Umile Giuseppe, De Salvatore Sergio, Piergentili Ilaria, Panattoni Nicolò, Marchetti Anna, De Marinis Maria Grazia, Denaro Vincenzo
Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy.
J Clin Med. 2023 Apr 20;12(8):2999. doi: 10.3390/jcm12082999.
Anxiety and depressive symptoms adversely affect surgical outcomes in patients with rotator cuff tear (RCT) undergoing surgical repair. Patients without a diagnosis of mood disorders, such as anxiety and depression, before rotator cuff repair (RCR) can be considered an optimal candidate for surgery. The objective of this prospective observational study was to evaluate the relationship between anxiety and depressive symptoms, using the Hospital Anxiety and Depression Scale (HADS) as an assessment tool, and patient-reported outcome measures in RCT after repair surgery. This study included patients with RCT undergoing arthroscopic rotator cuff repair (RCR). Forty-three patients were included who had completed the HADS, Constant Murley Score (CMS), and Short Form Health Survey 36 (SF-36) questionnaires before surgery and in the postoperative follow-up, at 1 month, 3 months, and 6 months. The Friedman test showed that there were statistically significant changes in the different times point for HADS ( < 0.001), anxiety subscale of HADS, i.e., HADS-A ( < 0.001), depression subscale of HADS, i.e., HADS-D ( < 0.001), CMS ( < 0.001), and SF-36 ( < 0.001). The average scores of HADS, HADS-A, and HADS-D improved at each follow-up, showing improvement in discomfort. From the third month after surgery, there was an improvement in anxiety and depression disorders related to improved quality of life, functionality, and pain perception. The trend remained stable until the sixth month of follow up. This study shows that anxiety and depressive symptoms in RCT patients are significantly reduced after RCR with subsequent important improvements in terms of functionality, ability to carry out activities of daily living, perceived pain, and quality of life.
焦虑和抑郁症状会对接受手术修复的肩袖撕裂(RCT)患者的手术结果产生不利影响。在进行肩袖修复(RCR)之前未被诊断出患有焦虑和抑郁等情绪障碍的患者可被视为手术的最佳候选人。这项前瞻性观察性研究的目的是使用医院焦虑和抑郁量表(HADS)作为评估工具,评估焦虑和抑郁症状与修复手术后RCT患者报告的结局指标之间的关系。本研究纳入了接受关节镜下肩袖修复(RCR)的RCT患者。43例患者在手术前以及术后1个月、3个月和6个月的随访中完成了HADS、Constant Murley评分(CMS)和简短健康调查36(SF-36)问卷。Friedman检验显示,HADS(<0.001)、HADS焦虑子量表即HADS-A(<0.001)、HADS抑郁子量表即HADS-D(<0.001)、CMS(<0.001)和SF-36(<0.001)在不同时间点有统计学上的显著变化。HADS、HADS-A和HADS-D的平均得分在每次随访时均有所改善,表明不适感有所改善。术后第三个月起,与生活质量、功能和疼痛感知改善相关的焦虑和抑郁障碍有所改善。这种趋势在随访的第六个月之前一直保持稳定。本研究表明,RCR后RCT患者的焦虑和抑郁症状显著减轻,随后在功能、日常生活活动能力、疼痛感知和生活质量方面有重要改善。