Anxiety and depression symptoms have been associated with higher pain and lower functional scores in patients with glenohumeral osteoarthritis (GHOA). These authors conducted an observational cohort study including 143 shoulders in 135 subjects undergoing total shoulder arthroplasty for glenohumeral osteoarthritis. The types of implants used and the methods used for addressing non-concentric glenoids are not specified.
Radiographs were reviewed for all 143 shoulders included. Advanced imaging was available for 60 shoulders. On initial review, there was 68.5% (99/143 shoulders) agreement on modified Walch glenoid morphology according to each subtype. Preoperative glenoid pathology was classed as either concentric wear (glenoid types A1 or A2) or eccentric wear (glenoid types B1, B2, B3, C, or D). When grouped as concentric vs. eccentric glenoids, initial review agreement improved to 86% (123/143 shoulders). 65 shoulders (45.5%) were graded as concentric and 78 shoulders (54.5%) were graded as eccentric following consensus analysis. Final Walch subtype classification included 26 shoulders graded as A1, 39 as A2, 8 as B1, 45 as B2, 23 as B3, and 2 as C. There were no glenoids graded as D.
Patients with anxiety and depression reported similar improvements in pain and function following TSA similar to those without depression or anxiety.
Patients with moderate-to-severe depression were less likely to want to undergo the same procedure again (p=.035) and were more likely to regret undergoing surgery.
The ASES scores were somewhat higher for the patients with non-concentric glenoid.
Comment: This article demonstrates an association between the degree of anxiety and depression with the preoperative and postoperative ASES scores. It does not suggest how this information might be used to improve the care of patients having shoulder arthroplasty. For example, how should patients undergoing TSA be screened for anxiety/depression? Should the presence of anxiety/depression influence the indications for surgery? Might the management of anxiety/depression preoperatively improve the outcomes of total shoulder arthroplasty?
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To see a YouTube of on how we do total shoulder arthroplasty, click on this link.
The ASES scores were somewhat higher for the patients with non-concentric glenoid.
Comment: This article demonstrates an association between the degree of anxiety and depression with the preoperative and postoperative ASES scores. It does not suggest how this information might be used to improve the care of patients having shoulder arthroplasty. For example, how should patients undergoing TSA be screened for anxiety/depression? Should the presence of anxiety/depression influence the indications for surgery? Might the management of anxiety/depression preoperatively improve the outcomes of total shoulder arthroplasty?
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To see a YouTube of on how we do total shoulder arthroplasty, click on this link.
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