Limited evidence supports that patients with depression and/or anxiety symptoms have less improvement in patient reported outcomes with total knee arthroplasty (TKA).

Rationale
One moderate quality study (Duiven 2013) and one low quality paper (Singh 2010) demonstrated less good outcomes in patients with anxiety/depression. There only being one moderate quality paper, the recommendation made was that limited evidence supports that patients with depression and/or anxiety symptoms have less improvement in patient reported outcomes with total knee arthroplasty.
 
  1. Duivenvoorden,T., Vissers,M.M., Verhaar,J.A., Busschbach,J.J., Gosens,T., Bloem,R.M., Bierma-Zeinstra,S.M., Reijman,M. Anxiety and depressive symptoms before and after total hip and knee arthroplasty: a prospective multicentre study. Osteoarthritis Cartilage 2013/12; 12: 1834-1840
  2. Singh,J.A., O'Byrne,M., Harmsen,S., Lewallen,D. Predictors of moderate-severe functional limitation after primary Total Knee Arthroplasty (TKA): 4701 TKAs at 2-years and 2935 TKAs at 5-years. Osteoarthritis Cartilage 2010/4; 4: 515-521