SOUL/BODY: Why Hip Doctors Track Emotions after Surgery

by Sheldon Lewis

To determine whether a patient has recovered from hip surgery, orthopedic surgeons measure hip function. If the clinical test results are good to excellent, the surgeon rates the operation a success. Unfortunately, we now know that many patients do not agree.

“Patients come in for checkups after their hip surgery and the doctor says, ‘Looks like you’re doing fabulously,’ and [the patients] respond, ‘No, I’m not. I ache,’” says Berton R. Moed, M.D., chair of the department of orthopedic surgery at St. Louis University School of Medicine, who followed 46 people who had surgery for hip fractures over a two-year period. “They’re not doing well, but why?” The answer appears to be their emotions, which Moed calls “the elephant in the exam room.” The source of the problem could be an underlying depression that preceded the surgery or a new depression brought on by the surgery.

In his study, published in the Journal of Bone and Joint Surgery, Moed recommends using the clinical exam by the orthopedic surgeon and a patient questionnaire to get a total measure of the patient’s recovery. Mental health professionals also might help. Mobility was rated most important in how patients experienced recovery, but their emotional state came in second.