Does pre-operative psychological distress affect patient satisfaction after primary total hip arthroplasty?

We investigated this in a multi-centre prospective study between January 1999 and January 2002. We dichotomised the patients into the mentally distressed (MHS ≤ 56) and the not mentally distressed (MHS > 56) groups based on their pre-operative Mental Health Score (MHS) of SF36.448 patients (340 not distressed and 108 distressed) completed the patient satisfaction survey. Patient satisfaction rate at five year was 96.66% (415/448). There was no difference in patient satisfaction or willingness to have the surgery between the two groups. None of pre-operative variables predicted five year patient satisfaction in logistic regression.Patient satisfaction after surgery may not be adversely affected by pre-operative psychological distress.Total Hip Replacement (THR) is recognised as a very successful surgical intervention with high patient satisfaction [1]. However, it is estimated that a significant proportion of the patients may remain unsatisfied following THR [2]. Researchers have analysed various preoperative patient characteristics in an attempt to identify the best candidates for surgery and to identify the factors that are likely to predict poor patient satisfaction postoperatively [3-7]. The effect of patients' preoperative mental health on the outcome of joint replacement surgery has become an area of interest and has received some attention [8,9]. Researchers have shown that patients with preoperative mental distress are less likely to benefit after knee arthroplasty but the effect on outcome is less clear with THR [2,8-10].This prospective study investigated what effect preoperative mental health-assessed as psychological distress- had on patient satisfaction after THR. Our null hypothesis was that there was no difference in patient satisfaction after THR between patients who reported mental distress before surgery and those who did not.The Exeter Primary Outcome Study (EPOS) was a multi centre prospective cohort study of outcome after primary THR. Patients we