Patients with PTSD may have increased complication, infection risks after TKA
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Key takeaways:
- Patients with diagnosed PTSD may be at an increased risk for increased health care utilization and complications after knee arthroplasty.
- Results were compared with a cohort of patients without PTSD.
According to published results, patients with PTSD may be at an increased risk for postoperative ED visits, periprosthetic joint infections and revision surgery after total knee arthroplasty compared with patients without PTSD.
William J. Hlavinka, BS, a medical student at the Texas A&M School of Medicine, and colleagues performed a retrospective, propensity-matched study of data from 7,381 patients with a history of diagnosed PTSD and 7,381 patients without PTSD who underwent primary TKA.
Outcome measures were assessed at 1 month, 6 months, 2 years and 5 years and included postoperative health care visits and prescriptions, as well as overall complications and revisions.
Compared with patients without PTSD, Hlavinka and colleagues found patients with PTSD had statistically significantly increased rates of ED visits at 7 days postoperatively (34 visits vs. 54 visits, respectively; OR = 1.549), but not at 14 days (69 visits vs. 86 visits, respectively; OR = 1.214) or 1 month (94 visits vs. 123 visits, respectively; OR = 1.28).
In addition, Hlavinka and colleagues found patients with PTSD had increased rates of periprosthetic joint infection at 1 month (OR = 1.7) and 5 years (OR = 1.2), increased rates of periprosthetic fracture at 6 months (OR = 2.1) and 1 year (OR = 2.1) and increased rates of revision surgery at all postoperative follow-up timepoints.
Between the cohorts, Hlavinka and colleagues found no statistically significant differences in hospitalization rates at any postoperative follow-up timepoint or prescribed opioids, antipsychotics or antidepressants at 1-month follow-up.
“These findings underscore the importance of tailored early postoperative education and understanding outcomes for patients who have PTSD in contrast to those who do not have a diagnosis of PTSD,” Hlavinka and colleagues wrote in the study. “Future research should aim to verify these associations and evaluate appropriate preventative interventions to minimize postoperative complications in the setting of preexisting PTSD as well as correlations with other mental health conditions at large.”
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