Functional somatic syndromes linked to inferior outcomes and increased complications after hip and knee arthroplasty: study

Functional somatic syndromes (FSSs), defined as chronic physical symptoms with no identifiable organic cause, may impact results after hip and knee arthroplasty.

Masood et al conducted a study to perform a systematic review assessing the relationship between FSSs and clinical outcomes after primary total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA). It has been published in “Arthroplasty” journal. This systematic review was conducted and reported in adherence to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The primary outcome measures of this systematic review were baseline and postoperative patient-reported outcome measures of pain and function. Secondary outcome measures included postoperative opioid consumption, postoperative complication rates, revision or reoperation, and costs of care.

The PubMed and Web of Science databases were queried from January 1955 through December 2021 for studies investigating the impact of at least one FSS (fibromyalgia, irritable bowel syndrome (IBS), chronic headaches, and chronic low back pain) on outcomes after primary THA/TKA/UKA. Outcomes of interest included patient reported outcome measures (PROMs), postoperative opioid use, complications, revisions, and costs of care.

Key findings of the study were:

• There were twenty-eight studies, including 768,909 patients, of which 378,384 had an FSS.

• Five studies reported preoperative PROMs prior to THA/TKA, all of which showed worse PROMs among patients with at least 1 FSS diagnosis.

• Thirteen studies reported postoperative PROMs after THA/TKA, all of which demonstrated worse PROMs among patients with at least 1 FSS diagnosis.

• Patients with FSS diagnoses were more likely to continue using opioids at 3, 6, and 12 months following TKA, THA, and UKA.

• Medical and surgical complications, as well as revision rates, were higher among patients with FSSs.

The authors concluded that – “Patients with FSSs have inferior PROMs and are at increased risk for prolonged postoperative opioid use, medical and surgical complications, and revision after hip and knee arthroplasty. Improved understanding of the factors influencing the success of hip and knee arthroplasty is critical. Future studies should address the biopsychosocial determinants of health that can impact outcomes after total joint arthroplasty.”

Further reading:

Functional somatic syndromes are associated with inferior outcomes and increased complications after hip and knee arthroplasty: a systematic review

Masood et al.

Arthroplasty (2024) 6:2

https://doi.org/10.1186/s42836-023-00223-1