Medication Allergies MAY Be Correlated With Hip Scores

Researchers from Texas took a look at the existing research on mental well-being and its relationship to musculoskeletal conditions…then they dug deeper.

Their article, “Are Self-Reported Medication Allergies Associated With Worse Hip Outcome Scores Prior to Hip Arthroscopy?” appears in the June 2018 edition of Arthroscopy.

Co-author Joshua D. Harris, M.D., with Houston Methodist Orthopedic and Sports Medicine, told OTW, “Previous research has consistently demonstrated that psychiatric wellness plays a significant role in the outcome of multiple musculoskeletal conditions.”

“Relevant to the hip, our group (in addition to other groups in the U.S.) has shown that decreased psychiatric wellness (depression, anxiety, and other mood disorders) has been associated with inferior pre-operative patient-reported outcome scores, lower magnitudes of improvement following surgery, and ultimately lower post-operative patient-reported outcome scores.”

“Research has also shown significant associations between the presence of certain self-reported medication allergies and decreased psychiatric wellness. Thus, we wanted to determine if self-reported medication allergies were associated with hip-specific patient-reported outcome scores.”

“A total of 212 subjects were analyzed. Interestingly, 4 subjects reported an allergy to steroids (a common treatment for an allergic reaction); 72 subjects (34%) reported at least one medication allergy. The number of self-reported allergies was not significantly correlated with any of the hip-specific patient-reported outcome scores. Female gender was significantly associated with the number of self-reported medication allergies.”

“Although previous research has shown decreased psychiatric wellness in individuals with increased number of self-reported medication allergies, the small sample size of subjects in this investigation precluded any significant association of the number of self-reported medication allergies and hip-specific patient-reported outcome scores.”

“Nonetheless, the authors believe this is likely due to insufficient study power. The authors recommend increased awareness of psychiatric disorders in patients with multiple medication allergies. Appropriate diagnosis, referral, and treatment of these patients can optimize our outcomes and treat the whole patient, and not just the hip.”

“If a patient has multiple medication allergies, then surgeons need to have heightened awareness of the presence of a variety of mood and/or anxiety disorders (generalized anxiety, depression, adjustment, and personality disorders). If recognized, then referral may be warranted. Every case is unique. However, some patients may warrant pre-operative psychiatric treatment before undertaking elective orthopedic surgery. Others may already be in treatment and some may not need treatment. Only a qualified psychiatric professional can make that assessment. Psychiatric conditions in patients with musculoskeletal disorders are very common: ‘you may not see it, but it sees you.’ These are highly prevalent in all realms of musculoskeletal medicine and orthopedic surgeons must be able to recognize and refer.”