Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. Jun 19, 2026; 16(6): 116745
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116745
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116745
Preoperative anxiety and depression predict two-year outcomes after total hip or knee arthroplasty
Yi-Jun Lian, Jia-Ning Lu, Qing-Chao Ru, Yong-Kang Zhu, Zhen-Yang Yu, Xin Guo, Department of Orthopedics, The First Affiliated Hospital of Henan Medical University, Xinxiang 453100, Henan Province, China
Author contributions: Lian YJ and Guo X conceived and designed the study; Lian YJ, Lu JN, Ru QC, and Zhu YK collected the data; Lian YJ and Zhu YK performed the statistical analysis; Lian YJ drafted the manuscript; Lu JN and Zhu YK revised the manuscript; Guo X supervised the project and gave final approval. All authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Henan Medical University, China (No. HL2025EC-168).
Informed consent statement: Informed consent has been obtained for this study.
Conflict-of-interest statement: The authors declared that there were no conflicts of interest related to this study.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Yi-Jun Lian, Department of Orthopedics, The First Affiliated Hospital of Henan Medical University, No. 88 Jiankang Road, Weihui, Xinxiang 453100, Henan Province, China. lyj16373@126.com
Received: November 21, 2025
Revised: December 27, 2025
Accepted: February 25, 2026
Published online: June 19, 2026
Processing time: 188 Days and 0.1 Hours
Revised: December 27, 2025
Accepted: February 25, 2026
Published online: June 19, 2026
Processing time: 188 Days and 0.1 Hours
Core Tip
Core Tip: Anxiety and depression, as measured by the Hospital Anxiety and Depression Scale, before surgery have a long-term adverse effect on total hip arthroplasty and total knee arthroplasty outcomes. This study, which incorporates propensity score matching and two-year follow-up, shows anxiety and depression is an independent predictor of joint function, pain relief, quality of life, and complications. This research highlights the importance of psychological screening and interventions during the perioperative period in arthroplasty.