Anxiety and depression are associated with increased complications after total joint arthroplasty. Is the same true of bipolar and schizophrenic disorders?
Clinical outcomes following joint surgery in patients with schizophrenia or bipolar disorder have been understudied relative to depression and anxiety.
• Kheir and colleagues investigated the influence of schizophrenia and bipolar disorder on the outcomes of TJA with particular emphasis on peri-prosthetic joint infection, aseptic revisions, readmissions, and implant survivorship.
This study followed 156 patients with schizophrenia or bipolar disorder who underwent total joint arthroplasty.
Investigators compared rates of peri-prosthetic joint infection, aseptic revisions, readmissions, and implant survivorship with those of a group of matched controls.
• Patients were also more likely to be discharged to a rehabilitation facility (versus home).
• Potential study limitations include the retrospective design at a single institution.
1. Rasouli MR, Menendez ME, Sayadipour A, et al. Direct cost and complications associated with total joint arthroplasty in patients with preoperative anxiety and depression. J Arthroplasty. 2016;31:533e6. 2. Dickinson CM, Karlin DR, Nunez HR, et al. Do patients with pre-existing psychiatric illness have an increased risk of infection after injury? Surg Infect. 2017;18:545e9. 3. Cunningham DJ, Kavolus JJ, Bolognesi MP, et al. Common medical comorbidities correlated with poor outcomes in hip periprosthetic infection. J Arthroplasty. 2017;32:S241e245.e3. 4. Kheir MM, Kheir YNP, Tan TL, et al. Increased complications for schizophrenia and bipolar disorder patients undergoing total joint arthroplasty.J Arthroplasty. 2017 Dec 14. pii: S0883-5403(17)31094-X. doi: 10.1016/j.arth.2017.12.006.