Correlation Analysis Of Anxiety And Depression Around Arthroscopic Surgery In Patients With Secondary Frozen Shoulder Song Jianlin

Objective:Frozen shoulder is still a common and difficult problem in orthopaedic clinic.A large number of data show that patients with limited shoulder movement are widespread.Its main manifestation is that active and passive shoulder movements are significantly restricted.In recent years,the correlation between mood disorders and orthopaedic diseases has gradually attracted the attention of Orthopaedic doctors.It has been reported in orthopaedic literature abroad that there is a positive correlation between greater psychological stress and worse pain and functional score.Postoperative psychological status may be an important predictor of the outcome and prognosis of shoulder diseases.However,at present,there is no relevant data on psychological status of secondary frozen shoulder patients before and after arthroscopic surgery in China.The purpose of this study was to investigate the effects of anxiety and depression on pain and function in patients with secondary frozen shoulder before and after arthroscopic shoulder surgery.Methods:Fifty-six patients who underwent arthroscopic capsule release from January 2018 to October 20l8 in Dalian Central Hospital were selected.Visual analog scale(VAS),Constant Murley shoulder score system(C M S),Hospital Anxiety and Depression Scale(HADS)were used to evaluate the pain before and 6 weeks after operation.Estimate.In addition,preoperative demographic factors and clinical factors including age,sex,affected shoulder,education level,duration of shoulder pain,and course of shoulder stiffness were included in the assessment.Results:Before operation,15 of 56 patients(26.8%)showed depression:8(14.3%)had mild depression,7(12.5%)had moderate depression,13(23.2%)had anxiety:8(14.3%)had mild anxiety,3(5.3%)had moderate anxiety and 2(3.6%)had severe depression.Postoperatively.14 of 56 patients(25.0%)showed depression:12(21.4%)were mild depression,2(3.6%)were moderate depression,11(19.7%)showed anxiety:9(16.1%)were mild anxiety,2(3.6%)were moderate anxiety,and the number of severe anxiety was 0.The correlation analysis between preoperative psychological disorders and clinical outcome indicators showed that HADS-D score was negatively correlated with VAS pain score(r=0.241,P=0.037)and C M S score(r=0.355,P=0.001).HADS-A score was negatively correlated with VAS pain score(r=0.288,P=0.015)and C M S score(r=0.255,P=0.036).HADS-A and HADS-D scores were significantly correlated with duration(p=0.027 and P=0.018)and gender(p=0.010 and P=0.042).The correlation analysis between post-operative psychological disorders and clinical outcome indicators showed that:HADS-D score was positively correlated with VAS pain score(r=0.253,P=0.040),C M S score(r=0.389,P=0.003);HADS-A score was positively correlated with VAS pain score(r=0.215,P=0.031),C M S score(r=0.486,P=0.029).There was no correlation between preoperative age,education level and shoulder size(p>0.05).Preoperative HADS-A and HADS-D scores were significantly correlated with duration(p=0.027 and P=0.018)and gender(p=0.010 and P=0.042).In multivariate analysis,excluding other confounding factors,we found that ADS-D score was an independent predictor of CMS score(p=0.017).Conclusions:Preoperative depression and anxiety were negatively correlated with clinical outcomes after shoulder arthroscopy.Preoperative anxiety and depression in patients with secondary frozen shoulder improved or even disappeared after surgery.Depression after shoulder arthroscopy was an independent predictor of poorer clinical outcomes.Therefore,the effect of psychological state on postoperative clinical efficacy and prognosis should be considered in shoulder joint surgery of patients with secondary frozen shoulder.