PREOPERATIVE MENTAL HEALTH STATUS IN PATIENTS UNDERGOING PERIACETABULAR OSTEOTOMY CORRELATES WITH POORER OUTCOMES, SIMILAR IMPROVEMENT, AND IMPROVED ANXIETY/DEPRESSION SCORES POSTOPERATIVELY: A REGISTRY STUDY

Periacetabular osteotomy (PAO) is a recognised treatment for symptomatic acetabular dysplasia. Previous studies have shown mental health may be an important predictor of outcomes after PAO. This study explored the relationship of patient reported anxiety and depression to outcomes for a large registry cohort. We hypothesised that patients with increased anxiety/depression pre-operatively would: have worse outcomes be at risk of not achieving the functional improvements seen in patients with less anxiety/depression see an improvement anxiety/depression scores with improvement in functional scores Data were acquired from the UK Non-Arthroplasty Hip Registry dataset. Patients over 18 years old who underwent PAO were identified. Patient demographics and PROMs (EQ-5D-5L, iHOT-12) at pre-operative baseline and 1-year were recorded. EQ-5D-5L question 5 (Q5) addresses anxiety/depression and was used as a surrogate marker for anxiety/depression. The iHOT-12 score and EQ-5D-5L Health VAS (VAS) score were used to quantify health and hip outcomes. 478 patients were identified who had PAO between 2006–2024. Average age was 30.6 years (range:18-56) and 89.5% were females. Median pre-operative Q5 was 2 (IQR:1-3) and at 1-year it was 1 (IQR:1-2). Mean pre-operative iHOT-12 was 29.6 (SD:17.1) and at 1-year 61.1 (SD:25.7). Mean pre-operative VAS was 66.3 (SD:21.3) and at 1-year 71.1 (21.3). There was a significant moderate negative correlation between pre-operative Q5 and iHOT-12 and VAS at baseline/1-year. (iHOT-12: r=-0.30/-0.29, VAS: r=-0.32/-0.26). At 1-year there was a mean improvement in iHOT-12 and VAS scores of 30.9 (SD:25.5) and 4.6 (SD:20.3) respectively. There was no significant correlation between pre-operative Q5 and change in VAS at 1-year and there was a significant negative correlation with change in iHOT-12 at 1-year, but this was small (r=-0.10). There was a significant large positive correlation with change in Q5 with pre-operative Q5 (r=0.57). Our analysis showed that patients with higher anxiety/depression had poorer absolute outcomes, experienced near similar levels of PROMs improvement, and had greater improvement in their anxiety/depression at 1-year.