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Depression and Patient-Reported Outcomes Following Total Shoulder Arthroplasty.

Abstract Recent studies have found that depression is associated with increased pain and impairment following lower-extremity arthroplasty; however, this association has not been investigated for total shoulder arthroplasty. The objective of this study was to investigate the association between depression and patient-reported outcomes following total shoulder arthroplasty.
PMID
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Journal Title the journal of bone and joint surgery. american volume
Publication Year Start




PMID- 28419037
OWN - NLM
STAT- In-Process
DA  - 20170418
LR  - 20170418
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 8
DP  - 2017 Apr 19
TI  - Depression and Patient-Reported Outcomes Following Total Shoulder Arthroplasty.
PG  - 688-695
LID - 10.2106/JBJS.16.00541 [doi]
AB  - BACKGROUND: Recent studies have found that depression is associated with
      increased pain and impairment following lower-extremity arthroplasty; however,
      this association has not been investigated for total shoulder arthroplasty. The
      objective of this study was to investigate the association between depression and
      patient-reported outcomes following total shoulder arthroplasty. METHODS: A
      prospectively collected institutional registry was queried for consecutive
      patients who underwent total shoulder arthroplasty for osteoarthritis from 2007
      to 2013 with baseline and minimum 2-year postoperative American Shoulder and
      Elbow Surgeons (ASES) scores. Revision procedures and total shoulder arthroplasty
      for diagnoses other than osteoarthritis were excluded. Patients with a
      preoperative diagnosis of depression (n = 88) formed the study cohort; control
      patients without a diagnosis of depression were matched to the study patients by 
      age and sex in a 2:1 ratio (n = 176). Baseline characteristics and
      patient-reported outcome measures were compared between groups, as were minimum
      2-year patient-reported outcomes and change in patient-reported outcomes. A
      multivariable regression was performed to investigate the independent effect of
      depression on improvement in ASES scores. RESULTS: Except for the Short Form-12
      Mental Component Summary (SF-12 MCS) scores, there were no significant
      differences (p > 0.05) in baseline characteristics between study patients and
      controls. There was a significant improvement in the ASES score for patients with
      depression (p < 0.0001) and controls (p < 0.0001). Patients with depression had
      significantly lower final ASES scores (p = 0.001) and less improvement in ASES
      scores (p = 0.001) and SF-12 Physical Component Summary scores (p = 0.006) as
      well as lower satisfaction levels at 2 years; however, the latter difference did 
      not reach clinical importance. Depression (p = 0.018) was an independent
      predictor of less improvement in ASES scores. CONCLUSIONS: Patients with a
      diagnosis of depression should be counseled that they will experience a
      significant clinical improvement from baseline after total shoulder arthroplasty.
      A preoperative diagnosis of depression is an independent predictor of
      significantly less improvement in ASES scores following total shoulder
      arthroplasty; however, this difference does not reach clinical importance and
      should not discourage patients with a clinical diagnosis of depression from
      undergoing total shoulder arthroplasty. LEVEL OF EVIDENCE: Prognostic Level III. 
      See Instructions for Authors for a complete description of levels of evidence.
FAU - Werner, Brian C
AU  - Werner BC
AD  - 1Department of Orthopaedic Surgery, University of Virginia Health System,
      Charlottesville, Virginia 2Sports Medicine and Shoulder Surgery, Hospital for
      Special Surgery, New York, NY 3Department of Orthopaedic Surgery, TRIA
      Orthopaedic Center, Bloomington, Minnesota.
FAU - Wong, Alexandra C
AU  - Wong AC
FAU - Chang, Brenda
AU  - Chang B
FAU - Craig, Edward V
AU  - Craig EV
FAU - Dines, David M
AU  - Dines DM
FAU - Warren, Russell F
AU  - Warren RF
FAU - Gulotta, Lawrence V
AU  - Gulotta LV
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
EDAT- 2017/04/19 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/19 06:00
AID - 10.2106/JBJS.16.00541 [doi]
AID - 00004623-201704190-00009 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Apr 19;99(8):688-695. doi: 10.2106/JBJS.16.00541.

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