Etcheson JI, et al. - In this study, the patient perception of pain and opioid consumption following a total knee arthroplasty (TKA) or a total hip arthroplasty (THA) was compared between patients with and without major depressive disorder (MDD), with a special emphasis laid on comparing the pain intensity, lengths of stay (LOS), opioid consumption, and patient perception of pain control. Although not statistically significant, higher levels of postoperative pain were perceived by patients with major depressive disorder who underwent lower extremity joint arthroplasty, when compared with a matched non-depressed cohort. During the immediate post-operative period, the reported opioid consumption was more in total joint arthroplasty (TJA) patients with MDD vs their matched cohort. Patients’ course of recovery could be modulated by identifying patient-specific factors, such as MDD, which in turn, may improve outcomes and result in shorter hospital stays. Based on the growing opioid abuse epidemic, results of this inquiry warrant more cooperation between arthroplasty surgeons and primary care providers in order to optimize outcome and maximize value of care.