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Mood disorders are associated with inferior outcomes of anatomic total shoulder arthroplasty

Eads, Ryan B. MD; Brolin, Tyler J. MD; Smith, Richard A. PhD; Azar, Frederick M. MD; Throckmorton, Thomas W. MD

doi: 10.1097/BCO.0000000000000727

Background: Mood disorders (MD) have been associated with inferior outcomes after orthopaedic procedures, but little is known about their effect on total shoulder arthroplasty (TSA).

Methods: In patients with primary TSA and a minimum of 2 yr clinical and radiographic follow-up, documentation of depression, anxiety, and/or use of a prescription mood-stabilizing drug indicated MD. Prolonged narcotic use was patient-reported consumption at most recent follow-up or filled narcotic prescription within 3 mo in a statewide database.

Results: Chronic pain syndromes were more frequent in 24 patients with MD (76%) than in 63 without (1.6%), and narcotic use was higher (54% vs. 13%, respectively). There were no significant differences in range of motion, strength, complications, reoperations, or radiographic complications and none in the amount of improvement for any of the functional parameters.

Conclusions: Patients with MD were four times more likely to require narcotics for pain control, although function improved by an amount similar to the control group.

Level of evidence: Level III, retrospective comparison study.

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, Memphis, Tennessee

Financial Disclosure: Drs. Eads, Brolin, and Smith disclose no conflict of interest. Dr. Azar reports consultant fees from 90point6, Iovera, and Zimmer and publishing royalties from Elsevier. Dr. Throckmorton reports consultant and speaker fees from Zimmer Biomet and publishing royalties from Elsevier.

Correspondence to Thomas W. Throckmorton, MD, Campbell Foundation, 1211 Union Avenue, Suite 510, Memphis, TN 38104 USATel: 901-759-3270; fax: 901-759-3278; e-mail:

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