Increased rate of complications following total knee arthroplasty in patients with systemic sclerosis

Purpose Outcomes after total knee arthroplasty (TKA) for patients with systemic sclerosis (SSc) are poorly documented in the literature. The purpose of this study was to evaluate SSc as a potential risk factor for increased rate of complications after TKA. Methods Using the PearlDiver Mariner databa...

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Published in:International orthopaedics 2023-10, Vol.47 (10), p.2563-2569
Main Authors: Driskill, Elizabeth, Zhang, Zhichang, Chi, Jialun, Cui, Quanjun
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Zhang, Zhichang
Chi, Jialun
Cui, Quanjun
description Purpose Outcomes after total knee arthroplasty (TKA) for patients with systemic sclerosis (SSc) are poorly documented in the literature. The purpose of this study was to evaluate SSc as a potential risk factor for increased rate of complications after TKA. Methods Using the PearlDiver Mariner database, 2,002 patients with SSc undergoing primary TKA were identified and compared to matched controls of 19,892 patients without SSc. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to two years. 90-day ED-visit and inpatient readmission were also documented. Results Compared to the matched controls, patients with SSc demonstrated higher rates of medical complications such as cerebrovascular accident (1.5% vs 0.6%, p  
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The purpose of this study was to evaluate SSc as a potential risk factor for increased rate of complications after TKA. Methods Using the PearlDiver Mariner database, 2,002 patients with SSc undergoing primary TKA were identified and compared to matched controls of 19,892 patients without SSc. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to two years. 90-day ED-visit and inpatient readmission were also documented. Results Compared to the matched controls, patients with SSc demonstrated higher rates of medical complications such as cerebrovascular accident (1.5% vs 0.6%, p  &lt; 0.001), myocardial infarction (1.3% vs 0.3%, p  &lt; 0.001), and sepsis (1.1% vs 0.4%, p  &lt; 0.001). Additionally, patients with SSc displayed elevated rates of surgical complications, including wound complications (3.9% vs 2.2%, p  &lt; 0.001) and aseptic loosening at 90 days (0.2% vs 0.1%; OR 3.53 [1.13–9.28]), one year (0.7% vs 0.4%; OR 1.78 [0.96–3.05]), and two years (1.4% vs 0.9%; OR 1.68 [1.10–2.45]). Patients with SSc also had higher rates of emergency department visits (21.2% vs 11.4%, p  &lt; 0.001). Conclusions Patients with SSc are at higher risks of postoperative complications, encompassing both medical and surgical complications. Specifically, patients with SSc have a significantly higher likelihood of experiencing wound complications, cerebrovascular accident, and myocardial infarction. It is crucial for orthopaedic surgeons and patients alike to consider the elevated risks when determining a course of TKA for patients with SSc.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-023-05873-z</identifier><identifier>PMID: 37354225</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Medicine ; Medicine &amp; Public Health ; Original Paper ; Orthopedics</subject><ispartof>International orthopaedics, 2023-10, Vol.47 (10), p.2563-2569</ispartof><rights>The Author(s) under exclusive licence to SICOT aisbl 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s) under exclusive licence to SICOT aisbl.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c298t-b90b1a206b55cd8b96fe98d96953756f936d3eac781f83e484bc34cce9f9d29c3</cites><orcidid>0000-0003-4285-4488</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37354225$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Driskill, Elizabeth</creatorcontrib><creatorcontrib>Zhang, Zhichang</creatorcontrib><creatorcontrib>Chi, Jialun</creatorcontrib><creatorcontrib>Cui, Quanjun</creatorcontrib><title>Increased rate of complications following total knee arthroplasty in patients with systemic sclerosis</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose Outcomes after total knee arthroplasty (TKA) for patients with systemic sclerosis (SSc) are poorly documented in the literature. The purpose of this study was to evaluate SSc as a potential risk factor for increased rate of complications after TKA. Methods Using the PearlDiver Mariner database, 2,002 patients with SSc undergoing primary TKA were identified and compared to matched controls of 19,892 patients without SSc. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to two years. 90-day ED-visit and inpatient readmission were also documented. Results Compared to the matched controls, patients with SSc demonstrated higher rates of medical complications such as cerebrovascular accident (1.5% vs 0.6%, p  &lt; 0.001), myocardial infarction (1.3% vs 0.3%, p  &lt; 0.001), and sepsis (1.1% vs 0.4%, p  &lt; 0.001). Additionally, patients with SSc displayed elevated rates of surgical complications, including wound complications (3.9% vs 2.2%, p  &lt; 0.001) and aseptic loosening at 90 days (0.2% vs 0.1%; OR 3.53 [1.13–9.28]), one year (0.7% vs 0.4%; OR 1.78 [0.96–3.05]), and two years (1.4% vs 0.9%; OR 1.68 [1.10–2.45]). Patients with SSc also had higher rates of emergency department visits (21.2% vs 11.4%, p  &lt; 0.001). Conclusions Patients with SSc are at higher risks of postoperative complications, encompassing both medical and surgical complications. Specifically, patients with SSc have a significantly higher likelihood of experiencing wound complications, cerebrovascular accident, and myocardial infarction. It is crucial for orthopaedic surgeons and patients alike to consider the elevated risks when determining a course of TKA for patients with SSc.</description><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Original Paper</subject><subject>Orthopedics</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kL1uFTEQRi0EIjeBF6BALmkW_LtrlyiCJFIkmlBbXu9s4rBrLx5fRTdPH8MNlKmmmPN9mjmEfODsM2ds-IKMiV51TMiOaTPI7vEV2XElRae51a_JjknFO9FbfUJOEe8Z40Nv-FtyIgeplRB6R-AqhQIeYaLFV6B5piGv2xKDrzEnpHNelvwQ0y2tufqF_koA1Jd6V_K2eKwHGhPdGgypIn2I9Y7iASusMVAMC5SMEd-RN7NfEN4_zzPy8_u3m_PL7vrHxdX51-suCGtqN1o2ci9YP2odJjPafgZrJts-kIPuZyv7SYIPg-GzkaCMGoNUIYCd7SRskGfk07F3K_n3HrC6NWKAZfEJ8h6dMMIqYXupGiqOaGgXYoHZbSWuvhwcZ-6PXnfU65pe91eve2yhj8_9-3GF6X_kn88GyCOAbZVuobj7vC-p_fxS7RNJ0IjW</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Driskill, Elizabeth</creator><creator>Zhang, Zhichang</creator><creator>Chi, Jialun</creator><creator>Cui, Quanjun</creator><general>Springer Berlin Heidelberg</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4285-4488</orcidid></search><sort><creationdate>20231001</creationdate><title>Increased rate of complications following total knee arthroplasty in patients with systemic sclerosis</title><author>Driskill, Elizabeth ; Zhang, Zhichang ; Chi, Jialun ; Cui, Quanjun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c298t-b90b1a206b55cd8b96fe98d96953756f936d3eac781f83e484bc34cce9f9d29c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Original Paper</topic><topic>Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Driskill, Elizabeth</creatorcontrib><creatorcontrib>Zhang, Zhichang</creatorcontrib><creatorcontrib>Chi, Jialun</creatorcontrib><creatorcontrib>Cui, Quanjun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Driskill, Elizabeth</au><au>Zhang, Zhichang</au><au>Chi, Jialun</au><au>Cui, Quanjun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased rate of complications following total knee arthroplasty in patients with systemic sclerosis</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>47</volume><issue>10</issue><spage>2563</spage><epage>2569</epage><pages>2563-2569</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose Outcomes after total knee arthroplasty (TKA) for patients with systemic sclerosis (SSc) are poorly documented in the literature. The purpose of this study was to evaluate SSc as a potential risk factor for increased rate of complications after TKA. Methods Using the PearlDiver Mariner database, 2,002 patients with SSc undergoing primary TKA were identified and compared to matched controls of 19,892 patients without SSc. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to two years. 90-day ED-visit and inpatient readmission were also documented. Results Compared to the matched controls, patients with SSc demonstrated higher rates of medical complications such as cerebrovascular accident (1.5% vs 0.6%, p  &lt; 0.001), myocardial infarction (1.3% vs 0.3%, p  &lt; 0.001), and sepsis (1.1% vs 0.4%, p  &lt; 0.001). Additionally, patients with SSc displayed elevated rates of surgical complications, including wound complications (3.9% vs 2.2%, p  &lt; 0.001) and aseptic loosening at 90 days (0.2% vs 0.1%; OR 3.53 [1.13–9.28]), one year (0.7% vs 0.4%; OR 1.78 [0.96–3.05]), and two years (1.4% vs 0.9%; OR 1.68 [1.10–2.45]). Patients with SSc also had higher rates of emergency department visits (21.2% vs 11.4%, p  &lt; 0.001). Conclusions Patients with SSc are at higher risks of postoperative complications, encompassing both medical and surgical complications. Specifically, patients with SSc have a significantly higher likelihood of experiencing wound complications, cerebrovascular accident, and myocardial infarction. It is crucial for orthopaedic surgeons and patients alike to consider the elevated risks when determining a course of TKA for patients with SSc.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37354225</pmid><doi>10.1007/s00264-023-05873-z</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4285-4488</orcidid></addata></record>
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subjects Medicine
Medicine & Public Health
Original Paper
Orthopedics
title Increased rate of complications following total knee arthroplasty in patients with systemic sclerosis
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