title: Depressed patients feel more pain in the short term after total knee arthroplasty.
abstract: OBJECTIVE
  The hypothesis of this study was that depressive patients feel more pain in the immediate TKA postoperative period in comparison with non-depressed patients.
  
  
  METHODS
  The diagnosis of depression was made with the Geriatric Depression Scale Short Form. The Visual Analogic Score (VAS) was registered each 8 h during the first 3 days. The mean and maximum VAS and the number of analgesic rescues required in this period were calculated in 803 consecutive TKAs. The Knee Society Score (KSS), the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 (SF-36) scores were obtained preoperatively and at the 1-year follow-up.
  
  
  RESULTS
  Forty-eight (6%) of these patients were considered depressed. The results obtained in the depressed patients and non-depressed were, respectively, mean VAS (2.0 vs 1.0, p = 0.00), maximum VAS (5.3 vs 1.6, p = 0.00), and number of rescues needed (4.4 vs 1.8, p = 0.00). Although depressed patients scored worse in the functional and quality of life scores in the preoperative period, the improvement obtained (1-year outcomes minus preoperative outcomes) in the different scores was similar in both groups with the exception of the mental domain of the SF-36, which improved further in depressed patients (p = 0.00).
  
  
  CONCLUSIONS
  Depressed patients feel more pain in the immediate postoperative period. However, the improvement obtained in functional and referred quality of life scores is similar to non-depressed patients.
  
  
  METHODS
  II.
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain. rtorresclaramunt@parcdesalutmar.cat.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. rtorresclaramunt@parcdesalutmar.cat.
authors.forename: Raúl
authors.initials: R
authors.lastname: Torres-Claramunt
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Hinarejos
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Amestoy
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Leal
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Sánchez-Soler
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Puig-Verdié
authors.affiliation: Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Monllau
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000523:psychology*; D011788:Quality of Life; D020127:Recovery of Function
keywords: Arthroplasty; Depression; KSS; Knee; Outcomes; SF-36; TKA; Yesavage