Study: Preoperative behavioral health evaluations improve orthopedic recovery

Editor's Note

Meeting with a health behavior psychologist before orthopedic surgery can help patients identify and overcome barriers to recovery, leading to better surgical outcomes, according to a University of Missouri School of Medicine July 31 news article covering a study published in the Journal of Knee Surgery. The study found addressing mental health, lifestyle demands, and other personal challenges before a surgical procedure reduced the likelihood of treatment failure.

As detailed in the article, the research involved 99 patients undergoing osteochondral allograft transplantation, a donor tissue procedure used to restore damaged joints. The study’s lead behavioral health psychologist assessed each patient’s mental health and trauma history, identified life factors that could hinder adherence to postoperative instructions, and worked with patients to develop coping strategies. Commonly cited barriers included ongoing mental health issues and high-energy jobs or hobbies that could make postop restrictions harder to follow.

Only 7 patients, or 7%, reportedly required repeat surgery, and nonadherence was not significantly linked to treatment failure—a contrast to previous studies showing nonadherence could raise failure risk more than fifteenfold. Study co-author Kylee Rucinski attributed this improvement to the early identification and mitigation of obstacles, which may have helped patients stick to their rehabilitation plans. Senior author James Cook emphasized outcomes improved when care teams considered the patient as a whole rather than solely the medical issue, showing the value of integrated, patient-centered approaches.

While this study focused on joint restoration procedures, the article notes similar psychological evaluations have been applied to other surgeries, including bariatric and spinal cord procedures, with comparable benefits. The researchers noted expanding this approach faces challenges, such as a shortage of trained behavioral health psychologists, and suggested exploring alternative screening methods like structured worksheets or assessments by other professionals to identify at-risk patients in advance.