The impact of preoperative anxiety and depression on the prognosis of patients with painful accessory navicular.

OBJECTIVE

This study evaluated the clinical efficacy of modified Kidner procedures for painful accessory navicular(AN) syndrome. Furthermore, it investigated the differences between patients' pre- and post-operatively, analyzing the impact on post-operative pain and functional recovery.

METHODS

This study included 50 patients diagnosed with painful AN and treated with the modified Kidner procedure at the Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an, between May 2014 and May 2023. All patients were assessed using the Hospital Anxiety and Depression Scale (HADS), Visual Analogue Scale(VAS), and American Orthopaedic Foot & Ankle Society Midfoot Scale (AOFAS) before and after surgery. Patients were divided into two groups based on the presence of preoperative anxiety/depression symptoms. Patients without preoperative anxiety/depression were assigned to Group A, while those with preoperative anxiety/depression were assigned to Group B. The baseline data, pain, functional activity, and psychological status scores of both groups were compared, and a correlation analysis was conducted to identify factors associated with anxiety/depression.

RESULTS

Out of 50 patients with painful AN syndrome who completed follow-up, 28 exhibited symptoms of anxiety/depression preoperatively, resulting in an incidence rate of 56%.Both Group A and Group B patients showed significant improvements in all postoperative evaluation metrics compared to preoperative levels (p < 0.05), yet the overall prognosis for Group B was poorer than that for Group A.There were significant differences in the degree of improvement in pain, functional activity, and anxiety/depression between the two groups(p < 0.05).female patients had a significantly higher prevalence of anxiety than male patients (p < 0.05).

CONCLUSION

Modified Kidner surgery can significantly improve the function, pain, and psychological status of patients with painful AN.However, patients with less favorable preoperative psychological status tend to have less satisfactory outcomes.Patients with preoperative anxiety or depression symptoms experience more significant pain relief after surgery, while those without such symptoms show better functional recovery.Moreover, female patients with painful AN have a higher incidence of preoperative anxiety.Future research should further explore the impact of preoperative psychological interventions on outcomes.