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Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. Patients recorded in the Catalan...
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Published in: | BMC musculoskeletal disorders 2020-07, Vol.21 (1), p.447-447, Article 447 |
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creator | Arias-de la Torre, Jorge Smith, Kayla Dregan, Alexandru Valderas, Jose M Evans, Jonathan P Prieto-Alhambra, Daniel Lozano, Luis Molina, Antonio J Martín, Vicente Domingo, Laia Muñoz, Laura Espallargues, Mireia |
description | The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA.
Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years' follow-up was calculated, and adjusted Competing Risks models were fitted.
A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses.
Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA. |
doi_str_mv | 10.1186/s12891-020-03455-3 |
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Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years' follow-up was calculated, and adjusted Competing Risks models were fitted.
A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses.
Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA.</description><identifier>ISSN: 1471-2474</identifier><identifier>EISSN: 1471-2474</identifier><identifier>DOI: 10.1186/s12891-020-03455-3</identifier><identifier>PMID: 32646395</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Anemia ; Arthritis ; Arthroplasty (knee) ; Arthroplasty revision ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; Bone surgery ; Cancer metastasis ; Clinical decision making ; Comorbidity ; Datasets ; Decision making ; Diabetes ; Disease ; Hip replacement arthroplasty ; Hospitals ; Humans ; Hypertension ; Intervention ; Joint replacement surgery ; Joint surgery ; Knee replacement arthroplasty ; Liver diseases ; Metastases ; Musculoskeletal diseases ; Obesity ; Older people ; Osteoarthritis ; Patients ; Population ; Prostheses ; Psychosis ; Register studies ; Reoperation ; Retrospective Studies ; Surgical outcomes ; Total hip arthroplasty ; Total knee arthroplasty ; Weight control</subject><ispartof>BMC musculoskeletal disorders, 2020-07, Vol.21 (1), p.447-447, Article 447</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c563t-21d3ffebbf57c1b9ce2054caf56e7a29a4c4bc70b085bf5639cd9d88cc90c1353</citedby><cites>FETCH-LOGICAL-c563t-21d3ffebbf57c1b9ce2054caf56e7a29a4c4bc70b085bf5639cd9d88cc90c1353</cites><orcidid>0000-0001-6908-9611</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346613/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2424727211?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32646395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arias-de la Torre, Jorge</creatorcontrib><creatorcontrib>Smith, Kayla</creatorcontrib><creatorcontrib>Dregan, Alexandru</creatorcontrib><creatorcontrib>Valderas, Jose M</creatorcontrib><creatorcontrib>Evans, Jonathan P</creatorcontrib><creatorcontrib>Prieto-Alhambra, Daniel</creatorcontrib><creatorcontrib>Lozano, Luis</creatorcontrib><creatorcontrib>Molina, Antonio J</creatorcontrib><creatorcontrib>Martín, Vicente</creatorcontrib><creatorcontrib>Domingo, Laia</creatorcontrib><creatorcontrib>Muñoz, Laura</creatorcontrib><creatorcontrib>Espallargues, Mireia</creatorcontrib><title>Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty</title><title>BMC musculoskeletal disorders</title><addtitle>BMC Musculoskelet Disord</addtitle><description>The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA.
Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years' follow-up was calculated, and adjusted Competing Risks models were fitted.
A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses.
Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA.</description><subject>Anemia</subject><subject>Arthritis</subject><subject>Arthroplasty (knee)</subject><subject>Arthroplasty revision</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Bone surgery</subject><subject>Cancer metastasis</subject><subject>Clinical decision making</subject><subject>Comorbidity</subject><subject>Datasets</subject><subject>Decision making</subject><subject>Diabetes</subject><subject>Disease</subject><subject>Hip replacement arthroplasty</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intervention</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Knee replacement arthroplasty</subject><subject>Liver diseases</subject><subject>Metastases</subject><subject>Musculoskeletal diseases</subject><subject>Obesity</subject><subject>Older people</subject><subject>Osteoarthritis</subject><subject>Patients</subject><subject>Population</subject><subject>Prostheses</subject><subject>Psychosis</subject><subject>Register studies</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Surgical outcomes</subject><subject>Total hip arthroplasty</subject><subject>Total knee arthroplasty</subject><subject>Weight control</subject><issn>1471-2474</issn><issn>1471-2474</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1v1DAYhCMEoqXwBzggS1y4pPgzTi5IVQV0pUpc4Gw5zuuNt0kcbKfS_nuc3dJ2EfLBlv3M2GNNUbwn-JKQuvocCa0bUmKKS8y4ECV7UZwTLklJueQvn63Pijcx7jAmsmbN6-KM0YpXrBHnxXYzztok5C0yfvShdZ1Le-QnlHpAsfchlUhPHRqhc8tYJggjCi7erYoA9y66zLqM-6QH1Lv5QN9NAEiH1Ac_Dzqm_dvildVDhHcP80Xx69vXn9c35e2P75vrq9vSiIqlkpKOWQtta4U0pG0MUCy40VZUIDVtNDe8NRK3uBaZyRlM13R1bUyDDWGCXRSbo2_n9U7NwY067JXXTh02fNiq_CxnBlCszWrBqNbAOAdRa8nyHQANAWC2zV5fjl7z0ub4BqYU9HBienoyuV5t_b2SjFcVYdng04NB8L8XiEmNLhoYBj2BX6KinDIsmurw7o__oDu_hCl_1UpxSSUl5Ina6hzATdbne81qqq4qRnIbKKaZuvwPlUcHozN-Auvy_omAHgUm-BgD2MeMBKu1aupYNZWrpg5VU2u4D89_51Hyt1vsD_UgzyM</recordid><startdate>20200709</startdate><enddate>20200709</enddate><creator>Arias-de la Torre, Jorge</creator><creator>Smith, Kayla</creator><creator>Dregan, Alexandru</creator><creator>Valderas, Jose M</creator><creator>Evans, Jonathan P</creator><creator>Prieto-Alhambra, Daniel</creator><creator>Lozano, Luis</creator><creator>Molina, Antonio J</creator><creator>Martín, Vicente</creator><creator>Domingo, Laia</creator><creator>Muñoz, Laura</creator><creator>Espallargues, Mireia</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6908-9611</orcidid></search><sort><creationdate>20200709</creationdate><title>Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty</title><author>Arias-de la Torre, Jorge ; Smith, Kayla ; Dregan, Alexandru ; Valderas, Jose M ; Evans, Jonathan P ; Prieto-Alhambra, Daniel ; Lozano, Luis ; Molina, Antonio J ; Martín, Vicente ; Domingo, Laia ; Muñoz, Laura ; Espallargues, Mireia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c563t-21d3ffebbf57c1b9ce2054caf56e7a29a4c4bc70b085bf5639cd9d88cc90c1353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anemia</topic><topic>Arthritis</topic><topic>Arthroplasty (knee)</topic><topic>Arthroplasty revision</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Bone surgery</topic><topic>Cancer metastasis</topic><topic>Clinical decision making</topic><topic>Comorbidity</topic><topic>Datasets</topic><topic>Decision making</topic><topic>Diabetes</topic><topic>Disease</topic><topic>Hip replacement arthroplasty</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intervention</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Knee replacement arthroplasty</topic><topic>Liver diseases</topic><topic>Metastases</topic><topic>Musculoskeletal diseases</topic><topic>Obesity</topic><topic>Older people</topic><topic>Osteoarthritis</topic><topic>Patients</topic><topic>Population</topic><topic>Prostheses</topic><topic>Psychosis</topic><topic>Register studies</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Surgical outcomes</topic><topic>Total hip arthroplasty</topic><topic>Total knee arthroplasty</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arias-de la Torre, Jorge</creatorcontrib><creatorcontrib>Smith, Kayla</creatorcontrib><creatorcontrib>Dregan, Alexandru</creatorcontrib><creatorcontrib>Valderas, Jose M</creatorcontrib><creatorcontrib>Evans, Jonathan P</creatorcontrib><creatorcontrib>Prieto-Alhambra, Daniel</creatorcontrib><creatorcontrib>Lozano, Luis</creatorcontrib><creatorcontrib>Molina, Antonio J</creatorcontrib><creatorcontrib>Martín, Vicente</creatorcontrib><creatorcontrib>Domingo, Laia</creatorcontrib><creatorcontrib>Muñoz, Laura</creatorcontrib><creatorcontrib>Espallargues, Mireia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BMC musculoskeletal disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arias-de la Torre, Jorge</au><au>Smith, Kayla</au><au>Dregan, Alexandru</au><au>Valderas, Jose M</au><au>Evans, Jonathan P</au><au>Prieto-Alhambra, Daniel</au><au>Lozano, Luis</au><au>Molina, Antonio J</au><au>Martín, Vicente</au><au>Domingo, Laia</au><au>Muñoz, Laura</au><au>Espallargues, Mireia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty</atitle><jtitle>BMC musculoskeletal disorders</jtitle><addtitle>BMC Musculoskelet Disord</addtitle><date>2020-07-09</date><risdate>2020</risdate><volume>21</volume><issue>1</issue><spage>447</spage><epage>447</epage><pages>447-447</pages><artnum>447</artnum><issn>1471-2474</issn><eissn>1471-2474</eissn><abstract>The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA.
Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years' follow-up was calculated, and adjusted Competing Risks models were fitted.
A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses.
Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>32646395</pmid><doi>10.1186/s12891-020-03455-3</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-6908-9611</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Anemia Arthritis Arthroplasty (knee) Arthroplasty revision Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Knee - adverse effects Bone surgery Cancer metastasis Clinical decision making Comorbidity Datasets Decision making Diabetes Disease Hip replacement arthroplasty Hospitals Humans Hypertension Intervention Joint replacement surgery Joint surgery Knee replacement arthroplasty Liver diseases Metastases Musculoskeletal diseases Obesity Older people Osteoarthritis Patients Population Prostheses Psychosis Register studies Reoperation Retrospective Studies Surgical outcomes Total hip arthroplasty Total knee arthroplasty Weight control |
title | Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty |
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