{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:11:45Z","timestamp":1793049105114,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To analyze the influence of diagnosed mental disorders on postoperative outcomes after arthroscopic anterior cruciate ligament (ACL) reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using the TriNetX health network database, we evaluated postoperative complications and additional procedures of patients who underwent arthroscopic ACL reconstruction over a 20\u2010year period. Patients with a documented mental health disorder (e.g., anxiety or depression) within 1 year preceding surgery were compared with patients without mental health disorders. The cohorts were propensity\u2010matched for demographic and medical factors, including hypertension, type 2 diabetes, and obesity. Short\u2010 and long\u2010term outcomes were evaluated within 90 days and 3 years postoperative, respectively. A \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      analysis was performed to compare outcomes between the 2 cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 8,351 patients with diagnosed mental health disorders were propensity\u2010score matched at a 1:1 ratio with 82,127 patients without diagnosed mental health disorders. Within 90 days postoperative, patients with diagnosed mental health disorders demonstrated significantly greater odds of postoperative infection (\n                      <jats:italic>P<\/jats:italic>\n                      = .0042), lower limb mononeuropathy (\n                      <jats:italic>P<\/jats:italic>\n                      = .025), acute postoperative pain (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), knee stiffness (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), and any emergency department visit (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.0001). Within 3 years postoperative, these patients had significantly greater odds of opioid abuse (\n                      <jats:italic>P<\/jats:italic>\n                      = .0015), knee pain (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), patella fracture (\n                      <jats:italic>P<\/jats:italic>\n                      =.0008), and arthrocentesis\/aspiration\/injection (\n                      <jats:italic>P<\/jats:italic>\n                      = .0005) but significantly lower odds of ACL tear (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) and repeat ACL reconstruction (\n                      <jats:italic>P<\/jats:italic>\n                      = .0033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diagnosed mental health disorders were associated with increased short\u2010 and long\u2010term postoperative complications after ACL reconstruction but also demonstrated a potentially protective association with multiple postoperative outcomes, including decreased odds of additional ACL tears and reconstructions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective, comparative cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2025.05.037","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T11:54:14Z","timestamp":1750938854000},"page":"4724","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnosed Mental Health Disorders Are Associated With Greater Rates of Postoperative Complications, Additional Procedures, and Lower Anterior Cruciate Ligament Tears and Revision Rates After Anterior Cruciate Ligament Reconstruction"],"prefix":"10.1002","volume":"41","author":[{"given":"Ahad A.","family":"Kesaria","sequence":"first","affiliation":[{"name":"John Sealy School of Medicine The University of Texas Medical Branch Galveston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady P.","family":"Moore","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine The University of Texas Medical Branch Galveston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwatofe","family":"Alimi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation The University of Texas Medical Branch Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation The University of Texas Medical Branch Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"917","article-title":"Anterior cruciate ligament injury: Diagnosis, management, and prevention","volume":"82","author":"Cimino F.","year":"2010","journal-title":"Am Fam Physician"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-009-0964-z"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.31031\/OPROJ.2018.01.000525"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1805931"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.1.160032"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1248-4"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000053"},{"key":"e_1_2_4_9_1","first-page":"165","article-title":"Primary anterior cruciate ligament reconstruction: 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