gms | German Medical Science

Objectives: Psychological status may be an important predictor of outcome and patient satisfaction after periacetabular osteotomy for treatment of developmental dysplasia of the hip. No prior studies have considered this factor. The objective of the study was therefore to investigate the influence of psychological distress on postoperative health-related quality of life, joint-function, self-assessed pain and sports ability in patients undergoing periacetabular osteotomy (PAO).

Methods: 202 consecutive patients diagnosed with hip dysplasia who underwent PAO at our institution from 2015 to 2017 were included in the study and followed up at 63±10 months postoperatively. Of these, 101 with complete data sets entered the final analysis. PAO patients were assessed using standardized questionnaires. Psychological status was measured by Brief Symptom Inventory (BSI-18), health-related quality of life was raised with Short Form 36 (SF-36), hip functionality was measured by International Hip Outcome Tool (iHOT-12), Subjective Hip Value (SHV) and Hip Disability and Outcome Score (HOS). Furthermore surgery satisfaction and pain were assessed. The dependent variables (endpoints) were postoperative quality of life (SF36, HOS QoL), joint function (iHOT, SHV, HOS), patient satisfaction, and pain. Psychological distress was assessed by the Global Severity Index (GSI), somatization (BSI soma), depression (BSI depr), anxiety (BSI anx). Influence of psychological status was assessed by means of univariate and multiple multivariate regression analysis.

Results and conclusion: In multiple multivariate regression, postoperative GSI, BSI somatization, and BSI depression had a negative effect on postop SF-36 (e=-2.07, -3.05 and -2.67 respectively, p<.001***), iHOT-12 (e=-1.35 and -4.65 respectively, p<.001***), SHV (e=-1.20 and -2.71 respectively, p<.001***), HOS QoL (e=-2.09 and -4.79 respectively, p<.001***), HOS function (e=-1.00 and -3.94 respectively, p<.001***), and HOS sport (e=-1.44 and -5.29 respectively, p<.001***) and had an effect on postop NRS (e=0.13 and 0.37 respectively, p<.001***).

Psychological distress, depression and somatization disorders cause reduction in health-related quality of life, perceived joint function and sports ability. Pain perception is significantly increased by postoperative somatization. However, patient satisfaction with surgery is not affected.