Psychological status and clinical outcomes in ankle arthrodesis: preoperative predictors and postoperative changes

Purpose The aim of this study is to investigate the psychological status of patients with end-stage ankle osteoarthritis (OA), and to evaluate the impact of ankle arthrodesis (AA) on the patients’ psychological condition, as well as the influence of preoperative anxiety and depression symptoms on the clinical outcomes after AA surgery. Methods A retrospective observational study was conducted on 62 patients with end-stage ankle OA who underwent AA treatment at our hospital from January 2019 to December 2024. Based on the patients’ preoperative psychological status, they were divided into two groups: those with symptoms of anxiety/depression were included in Group A, and those without symptoms of anxiety/depression were included in Group B. The Hospital Anxiety and Depression Scale (HADS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Visual Analogue Scale (VAS) for pain were used to evaluate the patients before surgery and at the final follow-up. Independent sample t-tests and chi-square tests were used for between-group comparisons, and paired sample t-tests were used for within-group pre-post comparisons. P < 0.05 was considered statistically significant. Results Of the 62 patients with end-stage ankle OA who were fully followed up, 30 had symptoms of anxiety/depression before surgery, a prevalence rate of up to 48%. All evaluation indicators for patients in Groups A and B improved significantly after AA surgery compared to before surgery, but the overall prognosis for Group A was worse than Group B. Conclusion AA can effectively improve patients’ pain, functional activity, and psychological condition, and there is a significant correlation between the patients’ preoperative psychological status and the prognosis.