Inflammatory bowel disease is associated with increased complications after total knee arthroplasty

• Published in: The knee 2023-01, Vol.40, p.313-318
• Main Authors: Remily, Ethan A., Sax, Oliver C., Douglas, Scott J., Salib, Christopher G., Salem, Hytham S., Monárrez, Rubén G., Delanois, Ronald E.
• Format: Article
• Language: English
• Subjects: Arthroplasty, Replacement, Knee - adverse effects; Clostridium Infections - complications; Clostridium Infections - etiology; Colitis, Ulcerative - complications; Colitis, Ulcerative - surgery; Complications; Crohn Disease - complications; Crohn Disease - surgery; Humans; IBD; Inflammatory Bowel Diseases - complications; Inflammatory Bowel Diseases - surgery; Retrospective Studies; Risk Factors; TKA
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2022.12.010

Few studies investigate the influence of inflammatory bowel disease (IBD) on complications following total knee arthroplasty (TKA). Therefore, we compared complications and readmissions frequencies after TKA in patients with Crohn’s disease (CD) and ulcerative colitis (UC) to patients without IBD. A large administrative claims database was used to identify patients who underwent primary TKAs from 2010 to 2019 and had a diagnosis of IBD before TKA. Patients were stratified into two groups: those with CD (n = 8,369) and those with UC (n = 11,347). These patients were compared a control of 1.3 million patients without an IBD diagnosis. Chi-square and unadjusted odds ratios (OR) with 95% confidence intervals (CI) were used to compare complication frequencies. Multivariable logistic regression was used to evaluate independent risk factors for 90-day complications. Compared to patients without IBD, patients with IBD were associated with higher unadjusted 90-day odds for Clostridium difficile infection (CDI) (CD: OR 2.81 [95% CI 2.17 to 3.63]; p