Does Rotator Cuff Repair Improve Psychologic Status and Quality of Life in Patients With Rotator Cuff Tear?

Background Recently, psychological status, patient-centered outcomes, and health-related quality of life (HRQoL) in patients with scheduled or who underwent orthopaedic surgeries have been emphasized. The relationship between preoperative psychological status and postoperative clinical outcome in pa...

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Published in:	Clinical orthopaedics and related research 2015-11, Vol.473 (11), p.3494-3500
Main Authors:	Cho, Chul-Hyun, Song, Kwang-Soon, Hwang, Ilseon, Warner, Jon J. P.
Format:	Article
Language:	eng
Subjects:	Adult Aged Anxiety - diagnosis Anxiety - epidemiology Anxiety - psychology Chi-Square Distribution Conservative Orthopedics Depression - diagnosis Depression - epidemiology Depression - psychology Disability Evaluation Female Health Status Humans Male Medicine Medicine & Public Health Mental Health Middle Aged Musculoskeletal Pain - diagnosis Musculoskeletal Pain - epidemiology Musculoskeletal Pain - physiopathology Musculoskeletal Pain - psychology Musculoskeletal Pain - surgery Orthopedics Pain Measurement Prevalence Prospective Studies Quality of Life Recovery of Function Republic of Korea - epidemiology Risk Factors Rotator Cuff - physiopathology Rotator Cuff - surgery Rotator Cuff Injuries Shoulder Sleep Initiation and Maintenance Disorders - diagnosis Sleep Initiation and Maintenance Disorders - epidemiology Sleep Initiation and Maintenance Disorders - psychology Sports Medicine Surgery Surgical Orthopedics Surveys and Questionnaires Symposium: Psychosocial Aspects of Musculoskeletal Illness Tendon Injuries - diagnosis Tendon Injuries - epidemiology Tendon Injuries - physiopathology Tendon Injuries - psychology Tendon Injuries - surgery Time Factors Treatment Outcome
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Summary:	Background Recently, psychological status, patient-centered outcomes, and health-related quality of life (HRQoL) in patients with scheduled or who underwent orthopaedic surgeries have been emphasized. The relationship between preoperative psychological status and postoperative clinical outcome in patients with rotator cuff repair has not yet been investigated. Questions/purposes The primary objective of this study was to investigate changes in psychological status (depression, anxiety, insomnia) and HRQoL after rotator cuff repair. The secondary objective was to assess whether preoperative depression, anxiety, and insomnia predict clinical outcome after rotator cuff repair. Methods Forty-seven patients who underwent rotator cuff repair prospectively completed the visual analog scale (VAS) pain score, the UCLA Scale, the American Shoulder and Elbow Surgeons’ Scale (ASES), the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality-of-life Scale Abbreviated Version (WHOQOL-BREF) before surgery and at 3, 6, and 12 months after surgery. Repeated-measures analysis of variance was used to evaluate the serial changes in psychological parameters and outcome measurements. The chi-square test was also used to compare preoperative and postoperative prevalence of depression, anxiety, and insomnia. Finally, multiple regression analysis was applied to determine the relationship between preoperative psychological status and postoperative clinical outcome. Results With surgery, depression, anxiety, and insomnia decreased, whereas quality of life increased. The mean HADS-D and HADS-A scores and the mean PSQI score decreased from 3.7 ± 3.3, 4.3 ± 4.3, and 6.6 ± 3.6, respectively, before surgery to 2.1 ± 2.3, 1.4 ± 2.4, and 4.2 ± 3.3, respectively, at 12 months after surgery (HADS-D mean difference 1.6 [95% confidence interval {CI}, 0.6–2.6], p = 0.003; HADS-A mean difference 2.9 [1.5–4.4], p
ISSN:	0009-921X 1528-1132