Impact of psoriasis on THA and TKA outcomes: A systematic review

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-08-09 DOI:10.1016/j.jor.2025.08.007

Robert S. Chin , Andrew K. Chow , Charles R. Reiter , Brady Ernst , Matthew Smith , Joshua Setliff , John Cyrus , Jibanananda Satpathy

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引用次数: 0

Abstract

Introduction

Psoriasis is an autoimmune inflammatory condition that often intersects with orthopaedic care due to its connection to psoriatic arthritis. However, not all psoriasis patients develop psoriatic arthritis. Psoriasis patients may undergo hip or knee arthroplasties for reasons unrelated to psoriasis. This condition, marked by inflamed, scaly skin caused by an overactive immune system, may pose challenges for orthopaedic surgeries. This systematic review evaluated outcomes for psoriasis patients after total hip arthroplasty (THA) or total knee arthroplasty (TKA), focusing on postsurgical impact to inform additional considerations for patients.

Methods

Following PRISMA guidelines, a systematic search was conducted in Medline, Embase, Web of Science, and Cochrane (up to October 2024). Studies involving patients with psoriasis undergoing THA or TKA were analyzed for postoperative outcomes.

Results

359 studies were screened, 7 met inclusion criteria. Two studies focused on THA, three on TKA, and two examined both procedures. Patients with psoriasis undergoing THA showed increased risk of infections compared to non-psoriasis patients. For TKA, results were mixed in whether psoriasis led to higher infection rates. Psoriasis did not lead to increased revisions in both THA and TKA. Additionally, two studies found no significant differences in wound complications in TKA patients.

Conclusion

This systematic review underscores the importance of considering post-surgical complications in psoriasis patients undergoing either a THA or TKA. However, lack of research makes it difficult to generalize findings. Psoriasis is an important factor to consider for surgical outcomes, but further research is needed to clarify risks and optimize care for patients.

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银屑病对THA和TKA结果的影响：一项系统综述

银屑病是一种自身免疫性炎症，由于与银屑病关节炎有关，经常与骨科护理交叉。然而，并不是所有的银屑病患者都会患上银屑病关节炎。银屑病患者可能因与银屑病无关的原因接受髋关节或膝关节置换术。这种由过度活跃的免疫系统引起的皮肤发炎、鳞片状的情况，可能给矫形外科手术带来挑战。本系统综述评估了全髋关节置换术（THA）或全膝关节置换术（TKA）后银屑病患者的预后，重点关注术后影响，以告知患者其他注意事项。方法按照PRISMA指南，系统检索Medline、Embase、Web of Science和Cochrane（截止到2024年10月）。对银屑病患者行THA或TKA的研究进行了术后结果分析。结果共筛选359项研究，7项符合纳入标准。两项研究关注THA，三项研究TKA，两项研究两种手术。与非银屑病患者相比，接受THA治疗的银屑病患者感染风险增加。对于TKA，牛皮癣是否会导致更高的感染率，结果好坏参半。银屑病并未导致THA和TKA的修正量增加。此外，两项研究发现TKA患者的伤口并发症无显著差异。结论：本系统综述强调了银屑病患者接受THA或TKA手术后并发症的重要性。然而，由于缺乏研究，很难对研究结果进行概括。银屑病是手术结果的重要考虑因素，但需要进一步的研究来明确风险并优化患者的护理。

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

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.