Psychosocial Profiles of Indigent Patients with Severe Osteoarthritis Requiring Arthroplasty

This study documents the prevalence of Axis I diagnoses (ie, depression, anxiety, and others) and their effects on preoperative pain, disability, function, and quality of life assessments in an indigent population undergoing total joint arthroplasty. Consecutive indigent patients scheduled for total joint arthroplasty were categorized by psychosocial testing as either psychologically distressed (PD) or nonpsychologically distressed. Of the subjects, 38% were found to be psychologically distressed. The PD group had significantly lower measures on 7 of the 8 components of the Short Form-36, the Harris hip score, and Knee Society score (P <.05). The PD group also scored significantly worse on both the Western Ontario MacMaster (P <.001) and the Pain Disability Questionnaire (P <.001). There is a high prevalence of psychopathology in the indigent population undergoing total joint arthroplasty, exhibiting poorer scores on pain, disability, function, and quality of life measures before surgery.