Ankylosing spondylitis in patients undergoing total hip arthroplasty increases the risk of medical and implant-related complications: a case control analysis.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-09-01 Epub Date: 2024-08-16 DOI:10.1177/11207000241267706
Kevin L Mekkawy, Hugo C Rodriguez, Gino Mercadal, Raul G Gosthe, Harpal S Khanuja, Arturo Corces, Martin W Roche
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引用次数: 0

Abstract

Introduction: Ankylosing spondylitis (AS) is an inflammatory spondyloarthropathy, often involving the spine and sacroiliac joints. Total hip arthroplasty (THA) has been shown to be effective in improving pain and function in patients with AS with hip involvement. However, extraskeletal manifestations and altered mechanics in those with AS leads to increased complications. Thus, the aims of this study were to assess the effects that AS has on medical and implant complications, falls, length of stay, and readmissions following THA.

Methods: A retrospective review of the Mariner private insurance claims database was conducted from 2010 to 2020. All cases of THA and those with AS were identified using Current Procedural Terminology, and International Classification of Disease 9th and 10th revision codes. Patients who underwent THA with a diagnosis of AS were matched to non-AS patients 1:5 based on demographic and comorbidity profiles. 90-day medical complications, falls, and readmission rates, as well as 2-year implant complications were compared between cohorts.

Results: A total of 6509 AS patients were matched to 32,489 control patients. The AS group had significantly higher rates of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound complications, acute kidney injury, pneumonia, sepsis, transfusions, and falls when compared to the control group. The AS group had significantly higher rates of prosthetic joint infection, dislocation, mechanical loosening, and periprosthetic fracture (all p < 0.0001). Likewise, mean length of stay and readmissions were significantly greater in the AS group.

Conclusions: Ankylosing spondylitis in patients undergoing THA is associated with significant risk of medical and implant complications, as well as fall risk, length of stay, and readmission rates. These findings may allow orthopaedic surgeons to be more attentive in identifying those patients at risk and allow for more educated patient counseling and perioperative planning.

接受全髋关节置换术的患者患强直性脊柱炎会增加医疗和植入物相关并发症的风险:病例对照分析。
简介:强直性脊柱炎(AS)是一种炎症性脊柱关节病:强直性脊柱炎(AS)是一种炎症性脊柱关节病,常累及脊柱和骶髂关节。事实证明,全髋关节置换术(THA)可有效改善髋关节受累的强直性脊柱炎患者的疼痛和功能。然而,强直性脊柱炎患者的骨骼外表现和力学改变会导致并发症增加。因此,本研究旨在评估强直性脊柱炎对医疗和植入并发症、跌倒、住院时间和THA术后再入院的影响:方法:2010 年至 2020 年期间,对 Mariner 私人保险索赔数据库进行了回顾性审查。所有 THA 病例和有 AS 的病例均使用《当前手术术语》和《国际疾病分类》第 9 版和第 10 版修订代码进行识别。根据人口统计学和合并症特征,将接受 THA 手术并诊断为 AS 的患者与非 AS 患者进行 1:5 匹配。对不同组群的90天医疗并发症、跌倒和再入院率以及2年植入并发症进行了比较:共有6509名强直性脊柱炎患者与32489名对照组患者进行了配对。与对照组相比,强直性脊柱炎组的心肌梗死、脑血管意外、深静脉血栓、肺栓塞、尿路感染、伤口并发症、急性肾损伤、肺炎、败血症、输血和跌倒发生率明显更高。强直性脊柱炎组的假体关节感染、脱位、机械性松动和假体周围骨折发生率明显高于对照组(P均<0.0001)。同样,强直性脊柱炎组的平均住院时间和再住院率也明显高于对照组:强直性脊柱炎与接受全髋关节置换术的患者的医疗和植入并发症风险、跌倒风险、住院时间和再入院率密切相关。这些发现可能会让矫形外科医生更加注意识别有风险的患者,并为患者提供更有针对性的咨询和围手术期计划。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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