Depression After Knee Replacement Can Cause Worse Outcomes

Studies show that depression after knee replacement surgery is higher than other surgical patients, despite knee replacement surgery being seen as a “new lease on life”. But even more concerning is that it may lead to worse outcomes unless addressed.

A new research study “Perioperative inpatient Use of Selective Serotonin Reuptake Inhibitors Is Associated With a Reduced Risk of THA and TKA Revision,” recently published in the June 2018 edition of Clinical Orthopaedics and Related Research found that treating depression with selective serotonin reuptake inhibitors resulted in lower revision rates with knee replacement surgery.Depression after knee replacement sad man

The co-author, Hilal Kremers M.D. explained, “Arthritis patients with chronic joint pain commonly present with depression and various other mood disorders.”

“Previous studies suggest that when depressed arthritis patients undergo total hip or knee arthroplasty, they continue to experience worse functional outcomes, more surgical complications and more hospital readmissions.”

Anti-depressants Lowered Adverse Results

Lower complication rates of knee replacement surgery resulted from use of Serotonin Reuptake Inhibitors, a particular class of depression drugs used in the study.

While you can treat depression drugs, there are many people who avoid going that route. Color and Laugh Your Way Through Knee Replacement Recovery, a coloring book for knee replacement patients was designed to use coloring as a stress reliever and laughing as an antidote for depression both of which have been shown to be useful to patients in the post-surgical recovery period to keep patients positive and optimistic.

The knee replacement coloring book consists of 20 full page illustrations designed by expert illustrator Dave Allred to bring irreverently humorous scenarios to life: scenarios that help patients turn the table on their frustrations and challenges and instead poke fun at them.

While taking pain medication generally limits more robust intellectual activities like reading and doing work at home, patients have found that coloring pages is a suitable alternative that provides hours of calming diversionary activity.

Laughter Is Good Medicine

Depression after knee replacement-laughterThe Mayo Clinic reports that clinical research backs up the idea that laughter is good medicine. In fact, laughter doesn’t just lighten your mental load but it can actually induce bodily changes such as stimulating organs, activating and relieving your chemical stress response and soothing tension in stressed muscles.

Meanwhile according to the Cancer Treatment Centers of America, researchers have conducted studies to explore the impact of laughter on health. After evaluating participants before and after a humorous event (i.e., a comedy video), studies have concluded that episodes of laughter helped to reduce pain, decrease stress-related hormones and boost the immune system in participants.

Patients and caregivers alike are having great fun with the book. We now know that many knee replacement patients are struggling with depression after knee replacement as well as the challenges of the surgery itself.

What Users Are Saying

Got this after my first and before my second knee replacement. PERFECT! The author has really captured the entire recovery process very well. If you are heading for a knee replacement, or if you have a family member or friend getting one, this book, a set of first rough weeks of recovery! I showed this to my Orthopedic Surgeon during a follow up visit, he roared with laughter as he paged through it.

I bought this for my mom, who is a nurse, and she LOVED it!! These pages are filled with funny, but actual, situations patients will encounter before and after surgery!! Boredom will make the nicest person turn into a clawing crab and this book along with word searches and crossword puzzles are a must post op!!! I made copies and took to her PT appointments for the therapist to laugh at!! Every doctor should put these along with coloring pencils in a goody bag for their patients!! Five stars from me!!

I got this for a friend who had a knee replacement and she got so much happiness from it. I am glad I chose this book. She took it to show her Therapist and she said the Therapist was going to order some too. She said they laughed and laughed reading it. Thanks for the great product & service.

Instead of picking up a get-well card, flowers or even candy, which is detrimental to recovery; give the gift of laughter and enjoyment to bolster patients’ spirits and promote physical well-being during the knee replacement recovery period.


Patryk Stecz, Magdalena Wrzesińska, Klaudia Tabała, Katarzyna Nowakowska-Domagała. (2017) Emotional Distress Associated with Surgical Treatment and its Relationship with Coping Profiles Among Chronically ill Older Patients. Current Psychology 36:1, pages 174-183.


Studies show that depression after knee replacement surgery is more common than in other surgeries and correlated with worse outcomes. Coloring book promotes laughter and stress relief in patients as a drugless antidote to depression.

Michelle, PT
Michelle, PT

Michelle Stiles called "the no nonsense" therapist, by her patients, created a company called Cowboy Up Recovery after recognizing the bankruptcy of the present medical model. Too many people regard conventional medical wisdom as gospel, ignoring the subversive influences of Big Pharma and Big Medicine. She believes, Americans in general are being trained from an early age to defer to experts in numerous areas of life and losing the impulses for self-responsibility and self-reliance in the process. Over-diagnosis and over-medicating has become endemic. While thankful for the best miracles of modern medicine, she encourages people of all persuasions to listen to their bodies and seek out answers to maintain not just an absence of disease but optimal health. Her advice is: Cowboy Up, no one cares more about your health than you do.

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.