Abstract:

Background: TJR is one of the major orthopedic surgery which is indicated among patients with end stage osteoarthritis. Also patients presenting with end stage osteoarthritis because of the chronic nature of disease and its associated limitation to engagement in day to day activities patients usually presents with long lasting mental disorders symptoms. These symptoms are made worse because majority of affected age group are older people. Given the success from TJR, it might be expected that patients would also experience improvements in their symptoms of depression, especially once their pain has subsided and physical function has begun to improve. Yet, TJR surgery may negatively impact patient’s during post-surgical recovery. Specifically, TJR patients who have higher levels of depression, have higher rates of post-surgical delirium and 12-month mortality.

Aim: To determine prevalence of depression among patients post total joint replacement at Muhimbili Orthopaedic Institute.

Methodology. This study was conducted at MOI. It was a prospective cross-sectional study; where by data were collected directly from patients in post-operative wards from September to December 2022. The adjusted sample size was 68 patients who underwent primary total joint replacement using convenient sampling technique was used with regards to inclusion and exclusion criteria. There after data was analyzed by using a computer SPSS software version 20. Ethical clearance was obtained prior to data collection from CUHAS- Ethical Review Board and permission to conduct will be obtained from the Executive Director Of Muhimbili Orthopaedic Institute.

Results: Prevalence of depressive disorder among patient undergoing TJR was found to be 26.5 among study participants. According to the visual analogue scale, most had severe pain 51(75%) with a score of (8-10), followed by moderate pain 11(16.2%) with a score of (4-7) and finally mild pain 6(8.8%) with a score of (1-3). According to the (PHQ-9), most patients had mild depression (33) with a score of (5-9), followed by moderate depression (18) with a score of (10-14) and finally minimal depression (17) with a score of (1-4). Furthermore, this study showed that there is a significant relationship between sex, occupation, pain and depression among patients who underwent total joint replacement. Females showed the highest moderate 17(94.4%), mild 18(54.5%) and minimal depression 10(58.8%) as compared to the males respectively, also females were two times more likely to be affected with depression than males (AOR =2.36, 95%CI: (4.93-27.13), P-value 0.010). Formally employed study participants had the highest moderate depression proportion 11(61.1%) while the least being self-employed 2(11.1%), also the formally employed were three times more likely to be affected with depression than the self-employed (AOR= 3.733, 95%CI: (2.030-4.80), P-value 0.003 among those patients who underwent TJR.

Conclusion: Patient who had chronic osteoarthritis had increased chance of being depressed and these symptoms are usually co-occurring together with pain. Among patient undergoing TJR treatment not only pain should be addressed but also depression and other significant factors affecting its prevalence such as sex, age and occupation, where by important group of concern being female, formally employed or retired and people aged between 60-79 years.