Qian Hang, Wang Xu, Wang Pengbo, Zhang Guangyang, Liu Jun, Dang Xiaoqian, Guo Jianbin, Liu Ruiyu
Department of Orthopedics, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Ther Clin Risk Manag. 2023 Aug 15;19:675-684. doi: 10.2147/TCRM.S415564. eCollection 2023.
Hip ankylosis is a prevalent condition in patients with Ankylosing spondylitis (AS) that can significantly impact their psychological well-being. This study aimed to investigate the impact of Total Hip Arthroplasty (THA) on anxiety and depression among AS patients.
62 AS patients undergoing primary THA were recruited and separated into two groups based on preoperative hip motion. The 40 patients with hip mobility of 0° were assigned to group A, and others were assigned to group NA. Self-rating Anxiety Scale (SAS), Self-rating Depression scale (SDS), Harris hip scores (HHS) and 36-Item Short Form Survey (SF-36) were obtained one week before and there, six and twelve months after THA.
The study found that AS patients in group A had significantly higher levels of anxiety and depression (SAS score = 75.05±2.79, SDS index score = 0.74±0.02) compared to group B (SAS score = 54.58±3.35, SDS index score= 0.64±0.03, P=0.01). However, both groups showed significant improvements in anxiety and depression scores from there to twelve months after THA (P<0.001). Correlation analyses revealed that the improvement in group NA was associated with hip pain relief (p<0.001), while the improvement in group A was related to joint function, disease duration, age at THA and spine imaging lesions (p<0.001).
Some degree of anxiety and depression was present in both groups of AS patients. Levels of depression and anxiety were higher in patients with combined hip ankylosis. And their improvement was associated with improved hip function and quality of life after THA. Hip pain relief played a significant role in patients without hip joint ankylosis. The impact of the degree of lesion on spinal imaging on psychological status needs to be considered in both groups.
髋关节强直是强直性脊柱炎（AS）患者中的一种常见病症，会对其心理健康产生重大影响。本研究旨在调查全髋关节置换术（THA）对AS患者焦虑和抑郁的影响。
招募62例行初次THA的AS患者，并根据术前髋关节活动度分为两组。髋关节活动度为0°的40例患者被分配到A组，其余患者被分配到NA组。在THA术前一周以及术后3个月、6个月和12个月时，获取患者的自评焦虑量表（SAS）、自评抑郁量表（SDS）、Harris髋关节评分（HHS）和36项简短健康调查（SF-36）。
研究发现，与B组（SAS评分=54.58±3.35，SDS指数评分=0.64±0.03，P=0.01）相比，A组的AS患者焦虑和抑郁水平显著更高（SAS评分=75.05±2.79，SDS指数评分=0.74±0.02）。然而，两组患者在THA术后3个月至12个月时焦虑和抑郁评分均有显著改善（P<0.001）。相关性分析显示，NA组的改善与髋关节疼痛缓解相关（p<0.001），而A组的改善与关节功能、病程、THA时的年龄和脊柱影像学病变相关（p<0.001）。
两组AS患者均存在一定程度的焦虑和抑郁。合并髋关节强直的患者抑郁和焦虑水平更高。THA术后，他们的改善与髋关节功能和生活质量的提高相关。髋关节疼痛缓解在无髋关节强直的患者中起重要作用。两组均需考虑脊柱影像学病变程度对心理状态的影响。
