Adam Nguyen, Patrick J Tansey, Alexis B Sandler, Allen S Wang, Joseph C Wenke
{"title":"Restless Legs Syndrome Is Associated with Higher Rates of Dislocation After Total Hip Arthroplasty.","authors":"Adam Nguyen, Patrick J Tansey, Alexis B Sandler, Allen S Wang, Joseph C Wenke","doi":"10.1016/j.arth.2025.07.040","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Restless Legs Syndrome (RLS) is a neurological disorder that induces involuntary leg movements that may hinder compliance with postoperative hip precautions; however, its impact on total hip arthroplasty (THA) outcomes has yet to be investigated. This study seeks to evaluate the influence of RLS on THA by comparing complication rates between patients who have RLS and a propensity-matched control cohort.</p><p><strong>Methods: </strong>A retrospective analysis using a national database was conducted to identify patients who had a history of RLS who underwent THA between 2009 and 2022. This RLS cohort was propensity matched with a control cohort who did not have a history of RLS, and the rates of postoperative complications were identified. After propensity score matching, 3,204 RLS patients were identified per cohort. Absolute risks and odds ratios (ORs) were calculated for both study groups.</p><p><strong>Results: </strong>Our analysis demonstrated a higher risk of dislocation (OR: 1.64, P = 0.043), emergency department utilization (OR: 1.19, P = 0.027), and a decreased risk of readmission (OR: 0.63, P = 0.001) in patients who had RLS within 90 days postoperatively than in those who did not have RLS. At two years, the incidence of aseptic loosening was 3.3% in the RLS cohort and 2.4% in the non-RLS cohort (OR: 1.37, P = 0.036). Similarly, the incidence of periprosthetic joint infection was 2.5% in the RLS cohort and 1.8% in the non-RLS cohort (OR: 1.42, P = 0.045).</p><p><strong>Conclusion: </strong>Restless legs syndrome was associated with a greater risk of periprosthetic dislocation and emergency department utilization, but a decreased readmission rate within 90 days of surgery, whereas aseptic loosening and periprosthetic joint infection were at greater risk at two-year follow-ups compared to the propensity-matched control cohort. These findings suggest a clinically relevant association that offers the opportunity to mitigate these complications through targeted interventions.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arthroplasty","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arth.2025.07.040","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Restless Legs Syndrome (RLS) is a neurological disorder that induces involuntary leg movements that may hinder compliance with postoperative hip precautions; however, its impact on total hip arthroplasty (THA) outcomes has yet to be investigated. This study seeks to evaluate the influence of RLS on THA by comparing complication rates between patients who have RLS and a propensity-matched control cohort.
Methods: A retrospective analysis using a national database was conducted to identify patients who had a history of RLS who underwent THA between 2009 and 2022. This RLS cohort was propensity matched with a control cohort who did not have a history of RLS, and the rates of postoperative complications were identified. After propensity score matching, 3,204 RLS patients were identified per cohort. Absolute risks and odds ratios (ORs) were calculated for both study groups.
Results: Our analysis demonstrated a higher risk of dislocation (OR: 1.64, P = 0.043), emergency department utilization (OR: 1.19, P = 0.027), and a decreased risk of readmission (OR: 0.63, P = 0.001) in patients who had RLS within 90 days postoperatively than in those who did not have RLS. At two years, the incidence of aseptic loosening was 3.3% in the RLS cohort and 2.4% in the non-RLS cohort (OR: 1.37, P = 0.036). Similarly, the incidence of periprosthetic joint infection was 2.5% in the RLS cohort and 1.8% in the non-RLS cohort (OR: 1.42, P = 0.045).
Conclusion: Restless legs syndrome was associated with a greater risk of periprosthetic dislocation and emergency department utilization, but a decreased readmission rate within 90 days of surgery, whereas aseptic loosening and periprosthetic joint infection were at greater risk at two-year follow-ups compared to the propensity-matched control cohort. These findings suggest a clinically relevant association that offers the opportunity to mitigate these complications through targeted interventions.
背景：不宁腿综合征（RLS）是一种神经系统疾病，引起不自主腿部运动，可能妨碍术后髋关节预防措施的依从性；然而，其对全髋关节置换术（THA）结果的影响尚未被调查。本研究旨在通过比较RLS患者和倾向匹配对照队列的并发症发生率来评估RLS对THA的影响。方法：使用国家数据库进行回顾性分析，以确定2009年至2022年间接受THA的有RLS病史的患者。该RLS队列与无RLS病史的对照队列倾向匹配，并确定术后并发症的发生率。在倾向评分匹配后，每个队列确定了3,204例RLS患者。计算两个研究组的绝对风险和优势比（ORs）。结果：我们的分析显示，术后90天内发生RLS的患者脱位风险（OR: 1.64, P = 0.043）、急诊科使用率（OR: 1.19, P = 0.027）较高，再入院风险（OR: 0.63, P = 0.001）低于未发生RLS的患者。两年后，RLS组无菌性松动发生率为3.3%，非RLS组为2.4% （OR: 1.37, P = 0.036）。同样，RLS组假体周围关节感染的发生率为2.5%，非RLS组为1.8% （OR: 1.42, P = 0.045）。结论：不宁腿综合征与假体周围脱位和急诊使用的风险较高相关，但手术后90天内再入院率降低，而与倾向匹配的对照组相比，无菌性松动和假体周围关节感染在两年随访中的风险更高。这些发现提示了一种临床相关的关联，为通过有针对性的干预措施减轻这些并发症提供了机会。
期刊介绍：
The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
