Impact of Benign Prostatic Hyperplasia on Postoperative Complications and Periprosthetic Joint Infections After Total Joint Arthroplasty: A Systematic Review and Meta-Analysis
{"title":"Impact of Benign Prostatic Hyperplasia on Postoperative Complications and Periprosthetic Joint Infections After Total Joint Arthroplasty: A Systematic Review and Meta-Analysis","authors":"","doi":"10.1016/j.artd.2024.101552","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Total joint arthroplasty (TJA) is one of the most frequently performed surgical procedures each year, offering considerable cost-effectiveness and numerous benefits. However, certain postoperative complications can be observed following TJA. While the relationship between various comorbidities and these complications has been well-documented, this study aims to specifically investigate the impact of benign prostatic hyperplasia (BPH) on postoperative outcomes.</div></div><div><h3>Methods</h3><div>For this systematic review, we searched PubMed, Scopus, and Web of Science using terms like \"total hip arthroplasty,\" \"total knee arthroplasty,\" \"BPH,\" and \"benign prostatic hypertrophy.\" Screening of retrieved articles was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing complications in TJA between patients with and without preexisting BPH were eligible for inclusion. Data extraction was performed on the included articles, and their quality was assessed using the Newcastle-Ottawa scale. A meta-analysis was conducted using the Mantel-Haenszel method.</div></div><div><h3>Results</h3><div>This systematic review encompassed 4 articles evaluating TJA outcomes in men with a history of BPH, involving a total of 75,222 male cases. Among these, 17,183 cases (23%) presented with symptomatic BPH. The meta-analysis revealed that the incidence rate of periprosthetic joint infection did not significantly differ between BPH and non-BPH groups across both total hip and knee arthroplasty cases (odds ratio [OR] (95% confidence interval [CI]) = 1.28 [0.92-1.79]). However, postoperative urinary retention was significantly higher among patients with BPH (OR [95% CI] = 3.43 [2.04-5.78]). Additionally, patients with BPH exhibited a notably elevated incidence of postoperative urinary tract infection (OR [95% CI] = 2.55 [2.33-2.79]), as well as sepsis (OR [95% CI] = 1.31 [1.09-1.58]).</div></div><div><h3>Conclusions</h3><div>It is noteworthy that while patients with BPH are prone to certain complications, meta-analysis indicate that BPH cannot be considered a comorbidity that increases the risk of periprosthetic joint infection.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124002371","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Total joint arthroplasty (TJA) is one of the most frequently performed surgical procedures each year, offering considerable cost-effectiveness and numerous benefits. However, certain postoperative complications can be observed following TJA. While the relationship between various comorbidities and these complications has been well-documented, this study aims to specifically investigate the impact of benign prostatic hyperplasia (BPH) on postoperative outcomes.
Methods
For this systematic review, we searched PubMed, Scopus, and Web of Science using terms like "total hip arthroplasty," "total knee arthroplasty," "BPH," and "benign prostatic hypertrophy." Screening of retrieved articles was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing complications in TJA between patients with and without preexisting BPH were eligible for inclusion. Data extraction was performed on the included articles, and their quality was assessed using the Newcastle-Ottawa scale. A meta-analysis was conducted using the Mantel-Haenszel method.
Results
This systematic review encompassed 4 articles evaluating TJA outcomes in men with a history of BPH, involving a total of 75,222 male cases. Among these, 17,183 cases (23%) presented with symptomatic BPH. The meta-analysis revealed that the incidence rate of periprosthetic joint infection did not significantly differ between BPH and non-BPH groups across both total hip and knee arthroplasty cases (odds ratio [OR] (95% confidence interval [CI]) = 1.28 [0.92-1.79]). However, postoperative urinary retention was significantly higher among patients with BPH (OR [95% CI] = 3.43 [2.04-5.78]). Additionally, patients with BPH exhibited a notably elevated incidence of postoperative urinary tract infection (OR [95% CI] = 2.55 [2.33-2.79]), as well as sepsis (OR [95% CI] = 1.31 [1.09-1.58]).
Conclusions
It is noteworthy that while patients with BPH are prone to certain complications, meta-analysis indicate that BPH cannot be considered a comorbidity that increases the risk of periprosthetic joint infection.
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.