Next Article in Journal
Psychometric Properties of the Polish Version of the Parental Feelings Inventory
Next Article in Special Issue
COVID-19 Changed the Incidence and the Pattern of Pediatric Traumas: A Single-Centre Study in a Pediatric Emergency Department
Previous Article in Journal
A Review on Bacterial Contribution to Lignocellulose Breakdown into Useful Bio-Products
Previous Article in Special Issue
Associations between Hip Fracture Operation Waiting Time and Complications in Asian Geriatric Patients: A Taiwan Medical Center Study
Article

Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis

1
Orthopedic Surgery and Traumatology Service, Virgen de la Luz Hospital, 16002 Cuenca, Spain
2
Departments of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain
3
Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
4
Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain
5
Service of Traumatology, University Hospital Ramón y Cajal, 28034 Madrid, Spain
*
Author to whom correspondence should be addressed.
Academic Editors: Umile Giuseppe Longo and Vicenzo Denaro
Int. J. Environ. Res. Public Health 2021, 18(11), 5997; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115997
Received: 20 April 2021 / Revised: 27 May 2021 / Accepted: 29 May 2021 / Published: 3 June 2021
(This article belongs to the Special Issue The Burden of Orthopedic Surgery)
The outcome in total knee arthroplasty (TKA) depends on multiples factors, among them is the psychological condition. In addition, up 15 to 30% of the patients that undergo TKA show little or no improvement after surgery, which implies the diagnosis of a painful TKA is a challenge for the orthopedic surgeon, who must rule out a possible metal allergy (MA). It is considered an exclusion diagnosis. Due to the complex relationship between psychological condition and MA, and according to the worse results in patients treated with a hypoallergenic TKA, we asked: (1). What degree of psychological distress (PD) is present in patients who have a hypoallergenic TKA, and how does it influence the results of quality of life (QoL) and functional capacity. (2). Can we develop a new algorithm for patients with a possible MA that improves the outcomes? A pragmatic clinical study was carried out that included patients who underwent hypoallergenic TKA during three consecutive years. Quality of life and functional capacity were measured with (Western Ontario McMaster Universities Osteoarthritis Index) WOMAC index, the Short Form 12 questionnaire (SF-12) questionnaire, and the The EQ-5D-5L questionnaire essentially consists of two pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS) (Euro-QoL-5D L-VAS (EQ5D)), in all patients. To assess PD, a Psychological Distress Score was developed. SPSS software was performed to statistical analysis, and Student´s test for independent variables with a p < 0.005 as statistically significant. A total of 72 anallergic TKAs in 64 patients were treated during this period; 31.3% of these patients showed features of PD before the surgery. According with the severity of the PD, 60% were classified as severe, 10% as moderate and 30% as mild. Patients with PD had statistically significant worse results on the final WOMAC, SF-12, and EQ5D questionnaires. The final scores of the physical subscale of the SF-12 and EQ5D showed better results in patients diagnosed by psychiatrist. Up to one third of the patients with hypoallergenic TKAs have PD, and their results are clearly inferior to those patients with MA without PD. When PD was diagnosed according with Psychological Distress Score, patients should be carefully assessed in order to determine if a specialist referral is recommended. According with our results, PD should be assessed either by the PCP or by us. If the PD is confirmed, a psychiatry referral is then requested for better preoperative management and treatment. We believe that this approach would lead to better TKA outcomes. View Full-Text
Keywords: psychological distress; quality of life; total knee arthroplasty psychological distress; quality of life; total knee arthroplasty
Show Figures

Figure 1

MDPI and ACS Style

Peña, P.; Ortega, M.A.; Buján, J.; De la Torre, B. Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis. Int. J. Environ. Res. Public Health 2021, 18, 5997. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115997

AMA Style

Peña P, Ortega MA, Buján J, De la Torre B. Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis. International Journal of Environmental Research and Public Health. 2021; 18(11):5997. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115997

Chicago/Turabian Style

Peña, Pilar, Miguel A. Ortega, Julia Buján, and Basilio De la Torre. 2021. "Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis" International Journal of Environmental Research and Public Health 18, no. 11: 5997. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115997

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop