Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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The impact of mental health on shoulder arthroplasty and rotator cuff repair: a meta-analysis

  • Mohammad Daher (Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute) ;
  • Ryan Lopez (Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute) ;
  • Peter Boufadel (Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute) ;
  • Oscar Covarrubias (Department of Orthopaedics, Brown University) ;
  • Jack C. Casey (Department of Orthopaedics, Brown University) ;
  • George A. Casey (Department of Orthopaedics, Brown University) ;
  • Mohamad Y. Fares (Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute) ;
  • Joseph A. Abboud (Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute)
  • 투고 : 2024.02.26
  • 심사 : 2024.06.01
  • 발행 : 2024.09.01
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초록

Background: The aim of this study was to evaluate the impact of mental health attributes, such as the presence of psychiatric comorbidities or psychological comorbidities (low resilience), on outcomes after rotator cuff repair (RCR) and total shoulder arthroplasty (TSA). Methods: PubMed, Cochrane, and Google Scholar (results pages 1-20) were searched up to November 2023. Mental health problems of interest included the presence of psychiatric comorbidities (depression, anxiety) or indicators of poor psychological functioning, such as low resilience or the presence of distress. Patients were assigned to poor or good mental health groups in this study based on their grouping in the original study. Results: Fourteen studies were included in the meta-analysis. Patients with good mental health had greater improvements in postoperative American Shoulder and Elbow Surgeons and Simple Shoulder Test scores in the TSA cohort (P=0.003 and P=0.01), RCR cohort (P<0.001), and the combined TSA and RCR cohort (P<0.001). No difference was found in visual analog scale score, satisfaction, external rotation, or flexion between the two mental health groups. Patients with poor mental health undergoing RCR experienced higher rates of adverse events and transfusions (P<0.001). Patients with poor mental health also had greater rates of revision and emergency department visits in the TSA cohort (P<0.001), RCR cohort (P=0.05 and P=0.03), and combined cohort (P<0.001). Patients with poor mental health undergoing TSA had a higher rate of re-admission (P<0.001). Conclusions: Patients with poor preoperative mental health showed inferior patient-reported outcome scores and increased rates of adverse events, revisions, and re-admissions. Level of evidence: III.

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참고문헌

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