The effect of minor orthopaedic day surgery (MiODS) on patient’s mood.

A prospective population-based cohort study of 148 consecutive patients with age above 18 and less than 65, an American Society of Anaesthesiology (ASA) score of 1, and the requirement of general anaesthesia (GA) were included. The Medical Outcomes Study – Short Form 36 (SF-36), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used pre- and post-operatively.

The mean physical component score of SF-36 before surgery was 45.3 (SD = ±10.1) and 8 weeks following surgery was 44.9 (SD = ±11.04) [n = 148, p = 0.51, 95% CI = (−1.03 to 1.52)]. For the measurement of the changes in mood using BDI, BAI and SF-36, latent construct modelling was employed to increase validity. The covariance between mood pre- and post-operatively (cov = 69.44) corresponded to a correlation coefficient, r = 0.88 indicating that patients suffering a greater number of mood symptoms before surgery continue to have a greater number of symptoms following surgery. When the latent mood constructs were permitted to have different means the model fitted well with χ2 (df = 1) = 0.86 for which p = 0.77, thus the null hypothesis that MiODS has no effect on patient mood was rejected.

MiODS affects patient mood which deteriorates at 8 weeks post-operatively regardless of the pre-operative patient mood state. More importantly patients suffering a greater number of mood symptoms before MiODS continue to have a greater number of symptoms following surgery.

Total hip replacement is one of the most successful orthopaedic interventions in improving considerably the patients' performance, nevertheless some patients demonstrate declined functional ability following an operation. Such condition is not a consequence of medical illness or the surgery itself but might rather be associated with mental status. The authors conduct an investigation concerning the relation between some psychological and psychiatric factors and their influence on health-related quality of life in patients after total hip replacement.

Into the study group we included 102 subjects undergoing total hip replacement (59 female, 43 male). In all subjects we measured depression (Beck Depression Inventory – BDI), anxiety (State and Trait Anxiety Inventory – STAI), sense of coherence (SOC-29), personality traits (Eysenck Personality Inventory – EPI) and health related quality of life (SF-36).

The postoperative values of the PCS and the MCS for the whole group of patients correlated negatively with the SOC values (p = 0.04 and p = 0.03 respectively). Neuroticism (EPI) and anxiety as a trait (STAI) were also associated with postoperative performance, both in mental (p = 0.03 and p = 0.008 respectively) and physical (p = 0.005 and p = 0.04 respectively terms).

Total hip replacement improves significantly the patient’s health-related quality of life at 6 months after surgery, what is influenced by sense of coherence, neuroticism and anxiety as a trait. Above mentioned factors should be taken into account when rehabilitation and social readaptation processes are planned.