Purpose
To systematically review the associations between mental health and preoperative or
postoperative outcomes of hip arthroscopy for femoroacetabular impingement.
Methods
The literature search was conducted using the PubMed, EMBASE and PsychINFO databases
following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)
guidelines.
Results
Nine studies were identified that met the inclusion and exclusion criteria. All studies
assessing patient-reported outcomes found significantly lower patient-reported outcomes
(modified Harris Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome
Score–Sports-Specific Subscale, and International Hip Outcome Tool scores) related
to worse mental health functioning before surgery. Specifically, preoperative Hip
Outcome Score–Activities of Daily Living and Hip Outcome Score–Sports-Specific Subscale
were significantly greater in control patients than patients in the mental health
group by 11.6 points (mean difference; 95% confidence interval 7.58-15.79, P < .001) and 10 points (95% confidence interval 5.14-14.87, P < .001), without significant heterogeneity between studies (I2 = 28.59, P = .25; I2 = 0, P = .93), respectively. Patients with lower mental health status also had lower rates
of achieving a minimal clinically important difference in 5 studies included in this
review.
Conclusions
This systematic review finds consistent evidence supporting the association between
negative psychological function and worse preoperative and postoperative outcomes
for patients with hip disorders. Understanding both the effect of mental health on
surgical outcomes and the potential benefits of psychological intervention may represent
an opportunity to improve patient outcomes following hip arthroscopy.
Level of Evidence
IV, systematic review of Level II-IV studies.
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Article info
Publication history
Published online: June 01, 2022
Accepted:
May 12,
2022
Received:
January 19,
2021
Footnotes
See commentary on page 3207
The authors report the following potential conflicts of interest or sources of funding: K.F. reports consulting fees from DePuy Synthes and Vericel, and board or committee member, American Orthopaedic Society for Sports Medicine. F.T. reports consulting fees from DePuy Synthes; board or committee member, American Orthopaedic Society for Sports Medicine, American Academy of Orthopaedic Surgeons, and American Board of Orthopaedic Surgery; and stock or stock options, Trice Medical. ICMJE author disclosure forms are available for this article online, as supplementary material.
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