The impact of Behcet syndrome on total knee arthroplasty outcomes: a retrospective matched cohort study

• Published in: International orthopaedics 2023-08, Vol.47 (8), p.1989-1994
• Main Authors: Zhang, Zhichang, Driskill, Elizabeth, Chi, Jialun, Duensing, Ian, Cui, Quanjun
• Format: Article
• Language: English
• Subjects: Arthroplasty, Replacement, Knee - adverse effects; Behcet Syndrome - complications; Behcet Syndrome - epidemiology; Cohort Studies; Humans; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Patient Readmission; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Risk Factors
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-023-05850-6

Purpose Articu lar involvement is a common manifestation of Behcet syndrome (BS), which can eventually result in significant arthralgia and necessitate total knee arthroplasty (TKA). However, outcomes of BS patients after TKA are still poorly documented in the literature. The purpose of this study was to evaluate BS as a potential risk factor for complications after TKA. Methods BS patients undergoing primary TKA were identified from the PearlDiver Mariner database from 2010 to 2021 and compared to 10:1 matched controls. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to two years. Ninety-day emergency department (ED) visit and inpatient readmission were also documented. Results A total of 4286 patients undergoing primary TKA were queried, of which 390 had BS. Patients with BS demonstrated significantly higher rates of medical complications, including deep venous thrombosis. The rates of surgical complications were similar between the two groups with the exception of periprosthetic instability, aseptic loosening, and wound complications in BS patients. Additionally, a significantly higher rate of ED visits but markedly lower rates of 90-day readmissions were noted in patients with BS. Conclusion Patients with BS undergoing TKA are at higher risks of medical and surgical complications. Special considerations for a unique postoperative course with the higher complications should be made. It is crucial for orthopedic surgeons and patients alike to consider these risks when determining the expected course after TKA for patients with BS.