Optimized Patient Care in the Perioperative Management of Hip and Knee Arthroplasty: Mental Status and Arthroplasty

When performing a scientific literature search “for mental status and arthroplasty”, many studies with very heterogeneous study questions can be identified. Most studies have a retrospective design or analyze registry data, while only few studies have a prospective design. The number of prospective randomized controlled trials is very small. Therefore, the level of evidence is low and more high-quality studies are needed. Furthermore, mental status and outcome after TJA, like pain, function, patient satisfaction, and quality of life, are “soft parameters” that are most commonly assessed using patient-reported outcome measures (PROMs). Available results in this subgroup of patients often show a high variability, potential confounders like comorbidities may be present and some studies may not have enough statistical power to draw conclusions with sufficient evidence. Despite that limitation, this chapter aims to present the best available evidence on this clinically highly relevant topic.