Prevalence of Depressive Symptoms in Patients Undergoing Aseptic Revision Total Hip Arthroplasty Differs Based on Mode of Failure.

Background: Complications following total hip arthroplasty (THA) may necessitate a revision and patients who go on to a revision THA may experience depressive symptoms. The objective of this study was to investigate the prevalence of depressive symptoms before and after revision THA for six different failure modes.

Methods: Patients who underwent a THA revision with minimum 1-year follow-up at a single institution from 2008 to 2022 were retrospectively reviewed. Patients were grouped by failure modes: aseptic loosening, impingement, infection, instability, metallosis, polyethylene wear, and femoral stem pain. Preoperative and postoperative Veterans RAND 12-Item Health Scores and Harris Hip Score were compared.

Results: Twenty-four percent of patients in the retrospective cohort review had a previous existing mental health diagnosis, with depression being the most common (18% of all patients). The prevalence of depressive symptoms differed significantly by failure mode both preoperatively ( = .002) and postoperatively ( = .019). Veterans RAND 12 mental component score was significant between mode of failure groups both preoperatively ( < .001) and postoperatively ( = .005). Function significantly improved in all groups from preoperatively to postoperatively. Patients with depressive symptoms had significantly lower physical component score with instability, aseptic loosening, stem pain, and metallosis preoperatively ( < .001) and with instability, aseptic loosening, stem pain, and polyethylene wear postoperatively ( = .002).

Conclusions: Nearly 25% of patients with failed THA had a pre-existing mental health diagnosis and depressive symptoms were the most common. Unfortunately, depressive symptoms only improve modestly with revision surgery and can adversely affect a patient's functional outcome.