New-Onset Depression after Total Knee Arthroplasty: Consideration of the At-Risk Patient

Abstract Background Postoperative new-onset depression (NOD) has gained recent attention as a previously unrecognized complication which may put patients at risk for poor outcomes after elective total hip arthroplasty. We aimed to investigate risk factors for the development of NOD after total knee arthroplasty (TKA) and assess its association with postoperative complications. Methods This is a retrospective, population-level investigation of elective TKA patients. Patients with a preoperative diagnosis of depression were excluded from this study. Two groups were compared: patients who were diagnosed with depression within one year after TKA (NOD), and those who did not (control). The association of both preoperative patient factors and postoperative surgical and medical complications with NOD were then determined using multivariate and univariate analyses. Results Of 196,728 unique TKA patients in our cohort, 5,351 (2.72%) were diagnosed with NOD within one year of TKA. Age Conclusions Post-TKA NOD is common and is associated with poor outcomes. This may aid surgeons in developing both anticipatory measures and institute preventative measures for patients at risk for developing NOD.