{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:49:02Z","timestamp":1782978542227,"version":"3.54.5"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study evaluated the association between diagnosed mental health disorders and postoperative outcomes following Achilles repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was performed using the TriNetX database over a 20-year period. Patients were divided into 2 cohorts based on whether they had a documented mental health disorder (eg, anxiety or depression) 1 year preceding surgery. Cohorts were propensity score matched by demographics such as age, gender, body mass index, diabetes, and hypertension. Outcomes were measured 90\u2009days, 3\u2009years, and up to 10\u2009years using odds ratios with 95% CIs. \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      analysis was performed with significance noted at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Matched cohorts had a mean age of 48.5\u2009years in the mental health cohort and 49.6\u2009years in the control cohort, with 47.4% vs 47.1% female patients, respectively. A total of 1841 patients were included in each cohort. Within 90\u2009days postoperative, patients with diagnosed mental health disorders demonstrated several significant outcomes such as higher odds of orthopaedic aftercare (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.032), infection following a procedure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), postoperative pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), emergency department visit (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), ankle pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.004), cellulitis of lower limb (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001), and foot pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.009). Within 3\u2009years postoperative, these patients had significantly higher odds of knee pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008), ankle osteoarthritis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.003), Achilles tendonitis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008), and abnormalities of gait and mobility (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.020). Within 10\u2009years postoperative, these patients had significantly higher odds of ankle osteoarthritis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Diagnosed mental health disorders are associated with increased short- and long-term adverse postoperative outcomes in patients who underwent Achilles repair at a population level. These associations included increased infection rates and pain, as well as later musculoskeletal diagnoses such as ankle osteoarthritis and abnormalities with gait.<\/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":"10.1177\/24730114261457093","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:50:47Z","timestamp":1782730247000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Diagnosed Mental Health Disorders on Postoperative Outcomes After Achilles Tendon Repair"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7725-8984","authenticated-orcid":false,"given":"Ahad A.","family":"Kesaria","sequence":"first","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7996-159X","authenticated-orcid":false,"given":"Saadi M.","family":"Irfan","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan X.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6099-0435","authenticated-orcid":false,"given":"Verdinand C.B.","family":"Ruelos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX, USA"}],"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, Galveston, TX, 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