Depression's Impact on Total Ankle Arthroplasty Outcomes Revealed

Strategic Insights -

Depression has been found to negatively impact outcomes in patients undergoing total ankle arthroplasty (TAA), with individuals experiencing depression exhibiting poorer pain, functional, and complication rates compared to those without depression. Despite the growing use of TAA as a treatment for end-stage ankle arthritis, the impact of depression on TAA outcomes remains poorly understood. Researchers from the Aristotle University of Thessaloniki, in a systematic review of six studies involving approximately 9000 patients, found that patients with depression experienced worse postoperative pain, reduced improvement in functional outcomes, and higher risks of adverse events, including prolonged hospital stay and implant subsidence.

Key Takeaways:

  • Depression has been identified as a critical determinant of TAA outcomes, with patients experiencing depression exhibiting poorer pain, functional, and complication rates.
  • Six studies involving approximately 9000 patients were included in the systematic review, with five studies rated as good quality and one study rated as moderate quality.
  • Patients with depression experienced worse postoperative pain, reduced improvement in functional outcomes, and higher risks of adverse events, including prolonged hospital stay and implant subsidence.
  • The researchers recommend further prospective, multicenter studies and interventional trials to clarify causality and optimize perioperative care.
  • Panagiotis Konstantinou and colleagues from the Aristotle University of Thessaloniki conducted the systematic review, which was published in the Journal of Clinical Medicine.

Statistics:

  • Approximately 9000 patients were involved in the six studies included in the systematic review.
  • Five studies were rated as good quality on the Newcastle-Ottawa Scale, while one study was judged to be of moderate quality.
  • Four studies assessing pain outcomes consistently demonstrated worse postoperative pain or less improvement in patients with depression.
  • Three of five studies assessing functional or disability outcomes reported reduced improvement, while two studies found no independent association.
  • Two studies evaluating complications showed higher risks of adverse events, including prolonged hospital stay, non-home discharge, osteophytosis, and implant subsidence, among depressed patients.

Sources:

  • Influence of Preoperative Depression on Pain, Function, and Complications After Total Ankle Arthroplasty: A Systematic Review. Journal of Clinical Medicine, 2025;14(19):7080.