Assessing the relationship between wrist synovitis and anxiety: a study using clinical statistics and Mendelian randomization analysis

J Orthop Surg Res. 2025 Jan 3;20(1):3. doi: 10.1186/s13018-024-05432-1.

Abstract

Background: Wrist synovitis often leads to persistent pain, swelling, and limited mobility, causing significant functional impairment and psychological distress, including anxiety. Although arthroscopic synovectomy can alleviate physical symptoms, whether it also improves anxiety and the causal relationship between synovitis and anxiety remains unclear.

Methods: A prospective study was conducted on 44 patients diagnosed with wrist synovitis who underwent arthroscopic synovectomy. Patients were assessed preoperatively and at 2 and 4 weeks postoperatively using the Visual Analog Scale (VAS), Mayo Wrist Score, and Self-Rating Anxiety Scale (SAS). MR analysis was employed to investigate the causal relationship between wrist synovitis and anxiety using genome-wide association studies (GWAS) summary data.

Results: Significant reductions in SAS and VAS scores were observed at 2 and 4 weeks postoperatively, along with improvements in wrist function as measured by the Mayo Wrist Score. MR analysis did not find statistically significant evidence of a direct causal relationship between wrist synovitis and anxiety, though a positive trend suggests that wrist synovitis may be a risk factor for anxiety.

Conclusions: Arthroscopic synovectomy may alleviate anxiety symptoms and may improve wrist function in patients with wrist synovitis. While a direct causal link between wrist synovitis and anxiety was not conclusively established, the observed associations highlight the need for integrated management of physical and psychological health in these patients. Trial registration This study was retrospectively registered with the WuXi 9th People's Hospital (WuXi Orthopaedics Hospital) Medical Ethical Committee on August 6, 2023, with reference number KS2023081.

Keywords: Anxiety disorders; Arthroscopic synovectomy; Mendelian randomization; Physical and mental health interplay; Wrist synovitis.