Anxiety level a factor in function, pain following ankle surgery

LONG BEACH, Calif. — Results of a study presented at the American Orthopaedic Foot & Ankle Society Annual Meeting showed patients who underwent ankle surgery had reduced physical function and pain interference values when their anxiety levels were high compared with lower anxiety levels.

“We do see a drop in anxiety after surgery, so we are theorizing that nonoperative treatment may in fact be anxiety-provoking compared to surgical intervention,” Robert Grunfeld, MD, MSC, said during his presentation.

Grunfeld and colleagues evaluated 70 patients between multiple treatment centers for a forefoot disorder. PROMIS CAT physical function, anxiety and pain interference instruments were administered at the time of presentation and at 4, 8 and 12 weeks’ follow-up. Similar timeframes were used to evaluate patients treated nonsurgically and those who underwent surgical intervention after failing conservative treatment. T-tests were used to compare anxiety level, pain and physical function outcomes, and stratification was performed for both patient cohorts.

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Surgical intervention was shown to reduce physical function and pain interference significantly only in patients with baseline anxiety levels below 50, according to Grunfeld. Although no physical function improvement was found in patients with baseline anxiety levels 50 or above, improvement in pain interference was observed in these patients.

“We know that anxiety plays a role in orthopedic care, and longer follow-up may alter the influence these anxiety levels have on pain interference and physical function,” Grunfeld concluded. – by Christian Ingram

Reference:

Grunfeld R. Impact of anxiety on foot and ankle surgery outcomes. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 15-18, 2015; Long Beach, Calif.

Disclosure: Grunfeld reports no relevant financial disclosures.