Refraining from worry, anxiety and other negative moods and adopting a positive attitude are paramount to an orthopaedic patient\'s physical surgery outcome and recovery speed, according to a new review article published in the July 2006 issue of the Journal of the American Academy of Orthopaedic Surgeons. The article, based on a review of 29 studies of adult patients during a 15-year period (between 1990 and 2004), asserts that psychosocial factors -- the blend of psychological and social factors that potentially shape health, illness and disease -- are an important predictor of a patient\'s surgical recovery.

\"We found that the role psychosocial factors play in surgical recovery was even bigger than we expected,\" said Peter Jokl, MD, orthopaedic surgeon, professor, department of orthopaedics and rehabilitation, Yale University School of Medicine, and co-author of the article. \"Assessing a patient\'s mood and attitude may now give orthopaedic surgeons a better forecast in determining recovery.\"

In determining a patient\'s outcome, the article\'s authors developed a short series of questions and topics for the physician and patient to discuss. Questions about the existence (if any) of anxiety or depression, post-surgery expectations and level of confidence in pain management not only facilitate valuable dialogue between the patient and physician, but also create a partnership or team dynamic between the patient and the physician -- a key component of the American Academy of Orthopaedic Surgeons\' Patient-Centered Care initiative.

\"When it comes to recovery, orthopaedic surgeons often consider traditional clinical factors that influence surgical outcome -- the patient\'s age, physical health status or the degree of the injury, for example,\" said Patricia H. Rosenberger, PhD, associate research scientist in the Department of Epidemiology and Public Health at Yale University School of Medicine, and lead author of the article. \"This study went above and beyond those traditional factors and considered dynamics like stress, depression, social support, self-efficacy and positive expectations. We found that if a patient\'s mood and attitude are evaluated, orthopaedic surgeons can actually determine how a patient might physically recover and return to their normal daily activities.\"

According to Dr. Rosenberger, patients and physicians should recognize that recovery from surgery has many dynamics. \"Psychosocial factors play a large role in a patient\'s physical surgical outcomes, not just their quality of life,\" she said.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system including bones, joints, ligaments, tendons, and nerves.

The Journal of the American Academy of Orthopaedic Surgeons (JAAOS) is a publication of the 29,000-member American Academy of Orthopaedic Surgeons ( ) or ( ), the premier not-for- profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade ( ) -- the global initiative in the years 2002-2011 -- to raise awareness of musculoskeletal health, stimulate research and improve people\'s quality of life.

Abstracts and full text of the monthly, peer-reviewed JAAOS are available online at

American Academy of Orthopaedic Surgeons