Antiphospholipid Syndrome Increases Postoperative Complications After Total Hip and Knee Arthroplasty.

IF 1.1 4区医学 Q3 ORTHOPEDICS

Orthopedics Pub Date : 2024-06-27 DOI:10.3928/01477447-20240619-03

Ankit Hirpara, Melissa Carpenter, Michael Dayton, Craig Hogan

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引用次数: 0

Abstract

Background: Antiphospholipid syndrome (APS) is a systemic autoimmune condition that predisposes patients to venous thromboembolism (VTE). Although many studies have explored risk factors for VTE after joint reconstructive procedures, the impact of APS is still unclear.

Materials and methods: A retrospective cohort study was conducted using TriNetX, a health care database that includes 442,494 patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Ninety-day postoperative complications and 1- and 2-year surgical complications were compared between patients with and without preexisting APS. Patients underwent propensity score matching in a 1:1 ratio based on relevant comorbidities.

Results: Patients undergoing THA or TKA with APS, compared with those without, had higher rates of deep venous thrombosis (hip: 9.2% vs 6.0%, odds ratio, 1.589, P=.022; knee: 10.5% vs 4.1%, odds ratio, 2.763, P<.001), pulmonary embolism (hip: 6.9% vs 3.6%, odds ratio, 1.992, P=.005; knee: 8.4% vs 3.0%, odds ratio, 2.989, P<.001), and anemia (hip: 24.8% vs 18.6%, odds ratio, 1.447, P=.004; knee: 18.5% vs 13.9%, odds ratio, 1.406, P=.007). Patients undergoing THA with APS also had higher rates of urinary tract infection (5.0% vs 2.8%, odds ratio, 1.842, P=.029) and pneumonia (3.7% vs 1.8%, odds ratio, 2.119, P=.025). APS did not impact rates of surgical complications or revision surgery.

Conclusion: Overall, APS heightens patients' risk for complications after THA and TKA. Specific anticoagulation protocols and preoperative risk stratification should be implemented to reduce the risk of adverse events. [Orthopedics. 202;4x(x):xx-xx.].

查看原文本刊更多论文

抗磷脂综合征会增加全髋关节和膝关节置换术后并发症。

背景：抗磷脂综合征（APS）是一种全身性自身免疫性疾病，易导致患者发生静脉血栓栓塞（VTE）。尽管许多研究探讨了关节重建术后 VTE 的风险因素，但 APS 的影响仍不明确：一项回顾性队列研究通过 TriNetX 数据库进行，该数据库包括 442494 名接受全髋关节置换术（THA）或全膝关节置换术（TKA）的患者。对有和没有 APS 的患者的术后 90 天并发症以及 1 年和 2 年手术并发症进行了比较。患者根据相关合并症按1:1的比例进行倾向评分匹配：与没有APS的患者相比，接受THA或TKA手术的患者深静脉血栓形成率更高（髋关节：9.2% vs 6.0%，几率比1.589，P=.022；膝关节：10.5% vs 4.1%，几率比2.763，PP=.005；膝关节：8.4% vs 3.0%，几率比2.989，PP=.004；膝关节：18.5% vs 13.9%，几率比1.406，P=.007）。接受 THA 的 APS 患者尿路感染（5.0% vs 2.8%，几率比 1.842，P=.029）和肺炎（3.7% vs 1.8%，几率比 2.119，P=.025）的发生率也较高。APS不会影响手术并发症或翻修手术的发生率：总的来说，APS 会增加患者在 THA 和 TKA 术后出现并发症的风险。结论：总体而言，APS 会增加患者在 THA 和 TKA 术后出现并发症的风险，因此应实施特定的抗凝方案和术前风险分层，以降低不良事件的风险。[骨科。202;4x(x):xx-xx]。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopedics 医学-整形外科

CiteScore

2.20

自引率

0.00%

发文量

160

审稿时长

3 months

期刊介绍： For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.

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