Changes in postoperative depression and anxiety and their relationship with recovery from femoral head necrosis: A longitudinal study

BACKGROUND Femoral head necrosis (FHN) can significantly affect patients' psychological well-being and functional outcomes. However, the long-term relationship between postoperative depression, anxiety, and functional recovery in patients with FHN remains unclear. AIM To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years. METHODS Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study. Depression and anxiety status were assessed using the hospital anxiety and depression scale (HADS) at baseline, 6 months, 1, 2, and 3 years postoperatively. Functional recovery was evaluated using the Harris hip score (HHS). The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA; the relationship between depression/anxiety status and functional recovery was examined using Pearson’s correlation analysis. RESULTS The mean HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores significantly improved over time (P < 0.001). The prevalence of depression and anxiety decreased from 36.6% and 41.9% at baseline to 10.8% and 12.9%, respectively, at 3 years postoperatively. The mean HHS increased significantly from 52.3 ± 10.5 at baseline to 88.1 ± 7.2 at 3 years postoperatively (P < 0.001). Significant negative correlations were found between HADS-D/HADS-A scores and HHS at all time points (P < 0.05). CONCLUSION The severity of depression and anxiety negatively correlated with functional recovery, highlighting the importance of psychological interventions in the management of patients with FHN.