Psychiatric disease as a risk factor in fast-track hip and knee replacement

Recent studies suggest that patients with psychiat- ric disorders tend to do worse than patients without a psychiatric diagnosis when undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Whether this is due to their psychiatric condition, pharmacological treatment, a combination of the two, or something else has not been thoroughly analyzed—and there are no internationally accepted guidelines for perioperative man- agement of psychiatric patients. This overview summarizes our current knowledge on perioperative risks in patients with preop- erative psychiatric disorders and the possible role of psychotropic drugs in the perioperative course. This will be useful when plan- ning future strategies for improvement of surgical outcome fol- lowing hip and knee arthroplasty.