Psychological burden of bone and joint infections: Systematic review on mental health and quality of life implications

Table 4 Summary table

Ref.	Study design	Type of infection	Surgical treatment	Major mental health consequence
Wixted et al[15], 2022	Prospective	PJI, SA, OM	R/A (Girdlestone)	Moderate effects on mental health
Walter et al[16], 2024	Prospective	PJI	DAIR (7), OSE (1), TSE (19), Amputation (2)	The treatment of PJI can lead to a significant psychological burden, particularly anxiety and depression
Walter et al[1], 2021	Retrospective	FRI	Treatment performed but not specified	Mental health consequences are common after FRI and are often reflected in a range of depressive symptoms
Walter et al[17], 2021	Retrospective	PJI	DAIR (16) OSE (3) TSE (8) Arthrodesis (9)	The treatment of PJI can lead to a significant psychological burden, particularly depression
Knebel et al[18], 2020	Prospective	PJI	TSE	PJI represents a significant psychological stressor for patients, particularly in terms of fear of disease progression, anxiety, and depression
Maurer et al[8], 2022	Retrospective	FRI	Treatment performed but not specified	The mental well-being of affected patients remains impaired, even after successful treatment of FRI
Lueck et al[19], 2022	Prospective	PJI	TSE	HADS assessments indicate elevated levels of anxiety and depression in patients with PJI, especially during the intermediate phase of treatment
Walter et al[20], 2021	Retrospective	FRI	Gentamicin - coated intramedullary nail	Even after successful treatment, patients may continue to suffer from a reduced quality of life, particularly affecting the psychological sphere
Klim et al[21], 2023	Retrospective + Prospective	PJI (25), OM (23)	Treatment-resistant PJI or OM, living with a natural or iatrogenic sinus tract	Mental health is mildly affected
Helwig et al[22], 2014	Retrospective	PJI	DAIR, OSE/TSE, R/A	Quality of life is reduced, mental health is mildly affected
Walter et al[23], 2022	Retrospective	PJI (14), FRI (6)	Temporary arthrodesis with PMMA - coated intramedullary nail reinforced with cerclage wire	In the study cohort, a psychological symptom burden on the depression scale and elevated levels of anxiety were observed compared to healed patients
Abulaiti et al[24], 2017	Prospective	OM	Bone transport with external fixation ± membrane induction or bone grafting	External fixation had a negative impact on the patients’ mental health
Rowland et al[11], 2023	Retrospective	PJI	OSE/TSE	PJI can lead to significant physical limitations and social isolation, placing patients at increased risk for psychological distress, ranging from persistent worry to clinical depression
Wimalan et al[12], 2023	Retrospective	FRI	Treatment performed but not specified	FRI had a negative impact on mental well-being, as patients developed persistent anxiety and other psychological disturbances
Mallon et al[13], 2018	Retrospective	PJI	OSE/TSE	Profound physical, social, psychological, and financial disruptions were observed in all participants
Palmer et al[7], 2020	Retrospective	PJI	OSE/TSE	Adversely affected quality of life, particularly in terms of psychological well-being
Moore et al[14], 2015	Retrospective	PJI	OSE/TSE	Patients experienced psychological distress, such as anxiety and depression, especially during the interval period

PJI: Periprosthetic Joint Infection; OM: Osteomyelitis; SA: Septic arthritis; R/A: Resection or arthrodesis; DAIR: Debridement, Antibiotics, and implant retention; OSE: One-stage exchange; TSE: Two-stage exchange; FRI: Fracture-related infection; PMMA: Polymethyl methacrylate; HADS: Hospital Anxiety and Depression Scale.