# Impacts of preoperative anxiety and depression on pain and range of motion after arthroscopic frozen shoulder release: a cohort study

## TL;DR

This study found that patients with preoperative anxiety or depression had higher pain levels before and after frozen shoulder surgery, despite overall improvement in pain and mobility after a year.

## Contribution

The study demonstrates a novel link between preoperative psychological distress and persistent pain outcomes after frozen shoulder surgery.

## Key findings

- Patients with psychological distress (HADS ≥ 8) had higher preoperative and postoperative pain scores.
- All patients showed significant improvement in range of motion and pain scores at one-year follow-up.
- Psychological distress was associated with worse pain outcomes despite successful surgical intervention.

## Abstract

We aimed to evaluate the impact of preoperative anxiety and depression levels on baseline and postoperative pain in patients who underwent arthroscopic frozen shoulder release.

The study included 59 patients with more than three months of idiopathic frozen shoulder. All patients had arthroscopic frozen shoulder release. Two patients were excluded from statistical analysis. Therefore, the statistical analysis was performed on the remaining 57 patients. The patients were divided into two groups according to HADS scores: group 1 which included 28 patients with a healthy psychological status (anxiety ≤ 7 and depression ≤ 7), and Group 2, which included 29 patients with psychological distress ( anxiety ≥ 8 or depression ≥ 8).

The hallmark finding of this study is that patients complaining of frozen shoulder symptoms and having psychological distress (HADS ≥ 8) experienced higher pain scores preoperatively and at one-year follow-up after arthroscopic release. All patients showed significant improvement between the preoperative period and the one year follow-up regarding the abduction, forward flexion, external rotation at the side and the VAS pain score with a P value of 0.001.

Arthroscopic frozen shoulder release significantly lowers the VAS pain score over the 12-month.