The association between self-assessed improvement in mental health preceding rotator cuff repair and patient satisfaction: A retrospective cohort study

Background: The association between preoperative mental health trends and arthroscopic rotator cuff repair (RCR) outcomes and patient satisfaction has not been previously described. We investigated the association between a subjective change in preoperative mental health and patient-reported outcome measures (PROMs) and achievement of patient satisfaction and substantial clinical benefit (SCB), defined as an improvement of American Shoulder and Elbow Surgeons Standardized Shoulder Assessment score ≥ 17.5, following RCR. Methods: Among patients undergoing RCR, various PROMs were collected preoperatively and at follow-up intervals up to 2 years postoperatively. Patient satisfaction and achievement of SCB were analyzed relative to subjective reports of better, worse, or unchanged mental health in the year preceding RCR and preoperative PROMs. Results: Eighty-eight patients (47 male and 41 female) with a median age of 60.0 years (interquartile range (IQR), 10.0) were included in this study. All patients (n = 13) who reported improved mental health status preceding RCR had significantly better satisfaction (P = 0.03) and SCB (P ≤ 0.05) at 2 years postoperatively compared to patients who reported worse or unchanged mental status. Discussion: Subjective improvement in mental health status preceding arthroscopic RCR was associated with patient satisfaction and achievement of SCB at 2 years postoperatively.