Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2024-10-12 DOI:10.1016/j.artd.2024.101512

Christian DeMaio BS , Conner Patrick MD , Grayson Domingue MD , Jake Fox MD , Justin Dvorak PhD , Rishi Thakral MD

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引用次数: 0

Abstract

Background

Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article seeks to better characterize the complication risks in patients undergoing THA with SCD when compared to osteoarthritis (OA) using a large database from the National Inpatient Sample.

Methods

National Inpatient Sample data from 2006 through the third quarter of 2015 were analyzed using International Classification of Diseases, Ninth Revision codes. A weighted frequency of 4,350,961 THAs were recorded for OA and 4279 for SCD. These were compared using a Rao-Scott chi-squared test, and the prespecified complications were given sampling weights to approximate national estimates.

Results

The following complications were found to occur at a significantly increased frequency in patients with OA with SCD vs OA only: wound infection (0.69% vs 0.36%), dislocation (1.68% vs 0.80%), and urinary complications (3.61% vs 2.35%). SCD, when evaluated independent of avascular necrosis, was reported with higher frequency wound infection (0.86% vs 0.36%), and overall complications (7.25% vs 5.06%). Additionally, multiple comorbidities were significantly more prevalent in the SCD population compared to OA patients.

Conclusions

This study illustrates that patients with SCD have increased complication rates when compared to OA patients. This information benefits orthopaedic surgeons in preoperative and postoperative planning and counseling patients for realistic expectations. Furthermore, this study provides data that could benefit decision-making on bundled reimbursement for this specific patient population.

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镰状细胞病患者的全髋关节置换术并发症：对比研究

背景全髋关节置换术（THA）是美国最常见的骨科手术之一，但也存在一些罕见的并发症，这些并发症可能具有毁灭性。镰状细胞病（SCD）可导致股骨头血管性坏死，通常需要进行全髋关节置换术。本文试图利用全国住院病人抽样调查的大型数据库，更好地描述与骨关节炎（OA）相比，接受 THA 手术的 SCD 患者的并发症风险。方法利用国际疾病分类第九版代码分析了 2006 年至 2015 年第三季度的全国住院病人抽样调查数据。根据加权频率记录，OA 的 THAs 数量为 4,350,961 例，SCD 的 THAs 数量为 4279 例。结果发现以下并发症在伴有 SCD 的 OA 患者和仅伴有 OA 的患者中发生的频率显著增加：伤口感染（0.69% vs 0.36%）、脱位（1.68% vs 0.80%）和泌尿系统并发症（3.61% vs 2.35%）。在独立于血管性坏死进行评估时，SCD的伤口感染（0.86% vs 0.36%）和整体并发症（7.25% vs 5.06%）发生率较高。结论这项研究表明，与 OA 患者相比，SCD 患者的并发症发生率更高。这一信息有利于矫形外科医生制定术前和术后计划，并向患者提供切合实际期望的咨询服务。此外，本研究提供的数据还有利于针对这一特殊患者群体的捆绑报销决策。

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

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.