Association between disease-specific anxiety at discharge and functional outcome in patients after total knee arthroplasty.

Abstract

Patients who undergo total knee arthroplasty (TKA) may experience disease-specific problems, including decline in motor function and intense pain, which may result in disease-specific anxiety. This study aimed to investigate disease-specific anxiety at discharge, and any association between anxiety and functional outcomes following TKA. The study prospectively included 129 patients who had undergone TKA. Each patient's disease-specific anxiety about wounds, pain, gait, and falling was assessed at discharge using a numerical rating scale, in which 0 represented no anxiety and 10 represented the highest level of anxiety. In addition, patient-reported outcomes (PROs) were evaluated using the Knee Society Score (KSS) at six-months postoperatively. The effects of disease-specific anxiety at discharge were evaluated with the KSS at six-months postoperatively and analyzed separately using multiple regression analysis. The median score for anxiety about wounds, pain, and gait was 4.0 (IQR 2.0-5.0) at discharge five days after surgery. The median score for anxiety about falling was also 4.0 (IQR 2.0-6.0). The level of anxiety regarding wounds, pain, gait, and falling was negatively associated with the KSS six-months postoperatively after adjusting for all confounding factors (wounds: β = -2.8, 95% CI -4.3 to -1.3; pain: β = -3.4, 95% CI -4.9 to -1.9; gait: β = -4.3, 95% CI -5.8 to -2.9; falling: β = -2.5, 95% CI -3.9 to -1.1). Patients reported similar levels of anxiety regarding wounds, pain, gait, and falling at discharge after TKA. The severity of anxiety symptoms at discharge was negatively associated with PROs six-months postoperatively.