Effects of Depression and/or Anxiety on the Outcomes of Hip Arthroscopy for Femoroacetabular Impingement and Labral Tears: A Minimum 5-Year Follow-up Study
Authors
Quesada-Jimenez R, Walsh EG, Keane JC, Kahana-Rojkind AH, Domb ES, Domb BG
Background
Depression and anxiety are known to negatively affect outcomes in various orthopedic procedures. This study investigates how these mental health conditions impact intermediate-term outcomes following hip arthroscopy for femoroacetabular impingement (FAI) and labral tears.
Methods
A retrospective analysis was conducted on patients with a self-reported history of depression and/or anxiety who underwent primary hip arthroscopy for FAI and labral tears between 2008 and 2018. Patients were matched 1:1 to a control group without depression/anxiety using propensity score matching to control for confounding variables. Outcomes assessed included multiple patient-reported outcome (PRO) measures (mHHS, NAHS, HOS-SSS, iHOT-12, VAS, SF-12 Mental, and VR-12 Mental), patient satisfaction, revision surgeries, complication rates, and clinically meaningful thresholds (PASS).
Key Findings
- Both groups experienced significant improvements in all PROs over a minimum 5-year follow-up.
- The depression/anxiety group had:
- Lower preoperative scores for HOS-SSS, SF-M, and VR-M
- Lower final scores for mHHS, NAHS, HOS-SSS, SF-M, and VR-M
- Lower rates of achieving PASS for mHHS and HOS-SSS
- There was no significant difference in the rate of secondary procedures or complications between the groups.
- Despite starting and ending with lower scores, the magnitude of improvement was similar in both cohorts.
Conclusion
Patients with depression and/or anxiety can still achieve meaningful improvements in function and quality of life after hip arthroscopy. However, these patients may have lower starting and ending scores compared to those without mental health conditions, and are less likely to achieve symptom states that are considered acceptable.
What Does This Mean For Patients
Mental health plays a role in recovery after hip arthroscopy. While patients with depression or anxiety can improve significantly, they may start from a lower baseline and experience lower overall satisfaction or function long term. Addressing mental health alongside surgical care may help improve outcomes.