II. Department of Orthopaedic Surgery, Orthopaedic Hospital Vienna-Speising, Vienna, Austria; Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna-Speising, Vienna, Austria.
Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna-Speising, Vienna, Austria.
J Arthroplasty. 2024 Oct;39(10):2575-2580. doi: 10.1016/j.arth.2024.07.011. Epub 2024 Jul 14.
There is only sparse knowledge on the psychological burden of patients who have periprosthetic joint infections. The aim of our study was to assess the need for psychological support following total joint arthroplasty of the hip and knee. A special focus was set on patients who had aseptic and septic complications.
A total of 13,976 patients who underwent total hip (n = 6,926) or total knee arthroplasty (n = 7,050) between January 1, 2012 and December 31, 2019 at a single institution were retrospectively evaluated for the postoperative need for a psychological consultation. Data were collected on age, sex, type of surgery, and indications for revision procedures. The need for a psychological consultation was assessed during the daily postoperative visits, which were further coordinated by 2 institutional psychologists.
The average age was 68 years (range, 12 to 100), and there were 63.5% women. The overall rate of psychological consultations was 1.7%. Patients who had a septic indication for revision surgery had an 18.7-fold higher rate of postoperative psychological consultations compared to patients following primary surgery and a 5.4-fold higher rate compared to patients who had an aseptic indication. In detail, this rate was 1.0% in the primary subgroup, compared to 7.7% following revision arthroplasty (P < .001). In the revision subgroup, the rate was 17.9% for septic and 3.3% for aseptic revision arthroplasty cases (P < .001). Postoperative psychological consultations were twice as frequent in women (2.1%) compared to men (1.0%), P < .001.
The present study raises awareness of the markedly high psychological burden in revision arthroplasty cases, in the view of the high estimated number of unknown cases. There is a significant correlation between periprosthetic joint infectionsand the postoperative need for a psychological consultation, with women being at an even higher risk. Health care providers should aim at offering psychological support for patients who have a septic complication, with affected patients being at risk for psychological stress.
IV.
目前对于患有假体周围关节感染的患者的心理负担知之甚少。本研究旨在评估全髋关节和全膝关节置换术后患者对心理支持的需求。特别关注无菌性和感染性并发症的患者。
回顾性分析 2012 年 1 月 1 日至 2019 年 12 月 31 日期间在一家医疗机构接受全髋关节置换术（n=6926）或全膝关节置换术（n=7050）的 13976 例患者的术后是否需要心理咨询。收集年龄、性别、手术类型和翻修手术指征等数据。术后日常随访中评估是否需要心理咨询，由 2 名机构心理学家进一步协调。
平均年龄为 68 岁（12 岁至 100 岁），女性占 63.5%。总体心理咨询率为 1.7%。因感染而需要翻修手术的患者，与初次手术患者相比，术后接受心理咨询的可能性要高 18.7 倍，与无菌性患者相比，可能性要高 5.4 倍。具体来说，初次手术亚组的发生率为 1.0%，而翻修组为 7.7%（P<0.001）。在翻修亚组中，感染性翻修组的发生率为 17.9%，无菌性翻修组的发生率为 3.3%（P<0.001）。女性（2.1%）比男性（1.0%）更频繁地接受术后心理咨询，P<0.001。
本研究提高了对翻修关节置换术患者心理负担高的认识，鉴于未知病例数量估计较高。假体周围关节感染与术后心理咨询需求显著相关，女性风险更高。医护人员应针对感染性并发症患者提供心理支持，这些患者存在心理压力的风险。
IV。
