BACKGROUND Although total joint arthroplasty effectively treats end-stage joint diseases, 10%-30% of patients experience poor outcomes. Preoperative anxiety and depression are common, but their long-term prognostic impact remains unclear. This study aimed to investigate the association between preoperative anxiety/depression and two-year outcomes after total hip or knee arthroplasty. AIM To evaluate the impact of preoperative anxiety and depression on joint function, pain, quality of life, and c