Castle Joshua P, Gaudiani Michael A, Abbas Muhammad J, Halkias Eleftherios L, Pratt Brittaney A, Gasparro Matthew A, Wager Susan G, Moutzouros Vasilios, Makhni Eric C
Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
Wayne State University School of Medicine, Detroit, MI, USA.
J Orthop. 2025 Mar 17;70:63-69. doi: 10.1016/j.jor.2025.03.006. eCollection 2025 Dec.
To determine how screening positive for depression preoperatively can affect patient reported outcomes after anterior cruciate ligament reconstruction (ACLR).
Primary ACLR patients between May 2020-September 2022 with a PHQ-2 score prior to their surgery were retrospectively reviewed. Patients older than 13 years of age and with minimum 6-months of follow-up were included for analysis. Patients were categorized as PHQ(+) (PHQ-2 ≥2) or PHQ2(-) (PHQ-2 < 2). Demographics, preoperative and postoperative Patient Reported Outcome Information System (PROMIS) -Physical Function (PF) and Pain Interference (PI) scores, Patient Acceptable Symptomatic State (PASS), surgical clinical outcomes, and complications were collected and compared. Chi-square tests and independent t-tests were used for categorical and continuous variables, respectively.
A total of 127 patients were analyzed, with 32 PHQ2(+) and 95 PHQ2(-). The PHQ2(+) group had a lower proportion responding "yes" to PASS preoperatively (6.5 % vs. 25.3 %, p = 0.03), at 9 months (47.4 % vs. 72.4 %, p = 0.05), and 12 months postoperatively (42.9 % vs 79.5 %, p = 0.009). PHQ2(+) reported worse PROMIS-PI scores preoperatively, at 6 months, and at 9 months. The PHQ2(+) group reported worse PROMIS-PF preoperatively, at 6 months, at and 12 months. The PHQ2(+) group had worse IKDC scores preoperatively at 9 months and at 12 months. Those screening positive for depression also demonstrated a higher incidence of postoperative complications (34.4 % vs. 9.5 %, p = 0.001) and reoperation rates (21.9 % vs. 4.2 %; p = 0.002).
A brief preoperative survey, such as the PHQ-2, can provide prognostic value for patient outcomes after ACLR.
III-Retrospective cohort study.
确定术前抑郁症筛查呈阳性如何影响前交叉韧带重建（ACLR）术后患者报告的结局。
回顾性分析2020年5月至2022年9月期间接受初次ACLR手术且术前有PHQ-2评分的患者。纳入年龄大于13岁且随访至少6个月的患者进行分析。患者分为PHQ(+)组（PHQ-2≥2）或PHQ2(-)组（PHQ-2<2）。收集并比较人口统计学资料、术前和术后患者报告结局信息系统（PROMIS）-身体功能（PF）和疼痛干扰（PI）评分、患者可接受症状状态（PASS）、手术临床结局和并发症。分别使用卡方检验和独立t检验分析分类变量和连续变量。
共分析了127例患者，其中32例为PHQ2(+)，95例为PHQ2(-)。PHQ2(+)组术前对PASS回答“是”的比例较低（6.5%对25.3%，p=0.03），术后9个月（47.4%对72.4%，p=0.05）和12个月（42.9%对79.5%，p=0.009）。PHQ2(+)组术前、术后6个月和9个月的PROMIS-PI评分较差。PHQ2(+)组术前、术后6个月、9个月和12个月的PROMIS-PF评分较差。PHQ2(+)组术前、术后9个月和12个月的IKDC评分较差。抑郁症筛查呈阳性的患者术后并发症发生率也较高（34.4%对9.5%，p=0.001），再次手术率也较高（21.9%对4.2%；p=0.002）。
术前简短调查，如PHQ-2，可为ACLR术后患者结局提供预后价值。
III-回顾性队列研究。
