Psychological Factors Associated with Function and Health-Related Quality of Life Outcomes following Total Hip or Knee Arthroplasty: An Umbrella Review of Systematic Reviews.
Motahareh Karimijashni, Victoria Drouin, Caroline Béland et al.
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In 30 seconds
This umbrella review synthesised high-quality evidence from systematic reviews on psychological factors associated with function and health-related quality of life after total hip or knee arthroplasty. It included 25 systematic reviews covering 40,024 patients. Depression and anxiety were associated with poorer postoperative outcomes after both procedures. For knee arthroplasty, distress, kinesiophobia, pain catastrophizing, and pessimism were also associated with poorer outcomes; patient expectations and mental well-being were associated with better outcomes. The review identified no reviews addressing the latter vulnerability factors in hip arthroplasty.
Key findings
- Across 25 systematic reviews including 40,024 patients, depression and anxiety were associated with poorer function or health-related quality of life after hip or knee arthroplasty.
- After knee arthroplasty, distress, kinesiophobia, pain catastrophizing, and pessimism were also associated with poorer outcomes.
- Patient expectations and mental well-being were associated with better function or health-related quality of life after knee arthroplasty.
Why it matters
Psychological factors may help explain variation in recovery and quality of life after arthroplasty. Recognising the factors associated with poorer or better outcomes can inform assessment and support planning, while the evidence gaps—particularly for several factors after hip arthroplasty—caution against assuming that findings apply equally across procedures.
What to keep in mind
The review synthesised heterogeneous systematic reviews and included only high-quality studies in its qualitative synthesis. Several vulnerability factors were not addressed in reviews of hip arthroplasty.