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Background and purpose: The existence of psychological distress is considered a predictive factor for poorer outcomes in medical literature. The purpose was to assess the influence of total knee replacement (TKR) on psychological distress. Patients and Methods: Of a series of 265patients, 72 were mainly excluded due to cognitive impairment (65cases). The initial sample accomplished the visual analogue scale (VAS), the Knee Society Score, the Hospital Anxiety and Depression Scale (HADS) for distress and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) for quality of life. Subsequently, only the representative sample was divided into two groups as regards whether or not there was evidence of preoperative psychological distress. The statistical analysis consisted in the comparison of mean values from Test T-Student, ANOVA and a multiple-comparison study by Bonferroni method. Results: The preoperative distress proportion of women to men was 44.5% (61 / 137) to 10.7% (6/56). These outcomes resulted in a statistically significant value (P=0,015). A year after surgery, both groups improved all their scales decreasing the number of patients with distress (41.8%).However, the data were only statistically significant in the WOMAC scale (P=0.015). Interpretation: This study suggests that patients with preoperative distress further improve their quality of life as compared to those individuals who did not present it. It could be attributed to the physical and psychological improvement in the first group versus only the physical one in the second group. 226 Japan Journal of Medicine 2018; 1(5): 226 232 . doi: 10.31488/jjm.1000121

Could patients undergoing total knee replacement achieve an improvement on psychological distress?