Publication Name	World Journal of Psychiatry
Manuscript ID	113625
Country	China

Category	Psychology
Manuscript Type	Retrospective Cohort Study
Article Title	Preoperative anxiety and psychological determinants of functional recovery after total knee arthroplasty: A retrospective cohort study
Manuscript Source	Unsolicited Manuscript
All Author List	Song Shang, Yu Hu, Hai Wang, Rui-Qiang Rao and Fan Zhang
Funding Agency and Grant Number
Corresponding Author	Song Shang, Department of Orthopedics, Chongqing University Fuling Hospital, No. 2 Gaosongtang Road, Fuling District, Chongqing 408000, China. shangsong20251@163.com
Key Words	Total knee arthroplasty; Preoperative anxiety; Functional recovery; Psychological intervention; Postoperative rehabilitation
Core Tip	This study highlights the significant role of preoperative anxiety in determining functional recovery after total knee arthroplasty. Patients with elevated anxiety levels experienced longer hospital stays, poorer knee function, and higher complication rates. Mechanistic analyses revealed dysregulated neuroendocrine stress responses, increased pro-inflammatory cytokines, impaired treatment adherence, and sleep disturbances as mediating pathways. These findings underscore preoperative anxiety as a modifiable risk factor and emphasize the importance of integrating psychological assessment and targeted interventions into perioperative care. A multidisciplinary approach addressing both mental health and physical rehabilitation may optimize recovery outcomes.
Citation	Shang S, Hu Y, Wang H, Rao RQ, Zhang F. Preoperative anxiety and psychological determinants of functional recovery after total knee arthroplasty: A retrospective cohort study. World J Psychiatry 2025; In press

Received	2025-09-28 08:52
Peer-Review Started	2025-09-28 08:52
First Decision by Editorial Office Director	2025-10-21 06:17
Return for Revision	2025-10-21 06:17
Revised	2025-10-29 14:54
Publication Fee Transferred	2025-11-05 07:26
Second Decision by Editor	2025-12-12 02:35
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-12 08:30
Articles in Press	2025-12-12 08:30
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3206 (online)
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