类风湿关节炎患者肩关节置换术的结果和并发症：一项大型保险索赔匹配队列分析

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-03-15 DOI:10.1016/j.jor.2025.03.032

Catherine Hand, Camden Bohn, Chase Gornbein, Daanish Khazi-Syed, Josh Chang, Andrew Savoia, Brian Forsythe

{"title":"类风湿关节炎患者肩关节置换术的结果和并发症：一项大型保险索赔匹配队列分析","authors":"Catherine Hand, Camden Bohn, Chase Gornbein, Daanish Khazi-Syed, Josh Chang, Andrew Savoia, Brian Forsythe","doi":"10.1016/j.jor.2025.03.032","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation, pain, and stiffness, often progressing to joint erosion and deformity. Shoulder arthroplasty is a reliable treatment for alleviating severe arthritic pain in RA patients. This study examines the outcomes and complications of shoulder arthroplasty in individuals with RA.</div></div><div><h3>Methods</h3><div>A retrospective cohort study using the PearlDiver national insurance claims database identified patients over 18 who underwent primary shoulder arthroplasty, including anatomic, reverse, and hemiarthroplasty, between 2010 and 2020. Patients with preoperative RA were matched 1:2 with healthy controls by age and gender. Primary outcomes included revision arthroplasty and rotator cuff repair (RCR), while 90-day complications such as infections, wound disruption, and medical conditions were secondary outcomes. Statistical significance was assessed using multivariate and Chi-square analyses.</div></div><div><h3>Results</h3><div>Of 33,282 patients, 11,431 (34.3 %) had preoperative RA. The RA group exhibited significantly higher rates of 90-day complications, including infections (OR 4.4, p < 0.001), ED visits (OR 3.0, p < 0.001), cardiac arrhythmias (OR 3.0, p = 0.015), deep vein thrombosis (OR 1.3, p = 0.045), and pulmonary embolism (OR 4.2, p < 0.001). However, no significant differences were observed in revision or RCR rates between groups.</div></div><div><h3>Conclusion</h3><div>Patients with RA undergoing shoulder arthroplasty face increased risks of postoperative complications compared to controls, highlighting the need for tailored perioperative strategies to optimize outcomes in this high-risk population.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 96-100"},"PeriodicalIF":1.5000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes and complications of shoulder arthroplasty in patients with rheumatoid arthritis: A large insurance claims matched cohort analysis\",\"authors\":\"Catherine Hand, Camden Bohn, Chase Gornbein, Daanish Khazi-Syed, Josh Chang, Andrew Savoia, Brian Forsythe\",\"doi\":\"10.1016/j.jor.2025.03.032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation, pain, and stiffness, often progressing to joint erosion and deformity. Shoulder arthroplasty is a reliable treatment for alleviating severe arthritic pain in RA patients. This study examines the outcomes and complications of shoulder arthroplasty in individuals with RA.</div></div><div><h3>Methods</h3><div>A retrospective cohort study using the PearlDiver national insurance claims database identified patients over 18 who underwent primary shoulder arthroplasty, including anatomic, reverse, and hemiarthroplasty, between 2010 and 2020. Patients with preoperative RA were matched 1:2 with healthy controls by age and gender. Primary outcomes included revision arthroplasty and rotator cuff repair (RCR), while 90-day complications such as infections, wound disruption, and medical conditions were secondary outcomes. Statistical significance was assessed using multivariate and Chi-square analyses.</div></div><div><h3>Results</h3><div>Of 33,282 patients, 11,431 (34.3 %) had preoperative RA. The RA group exhibited significantly higher rates of 90-day complications, including infections (OR 4.4, p < 0.001), ED visits (OR 3.0, p < 0.001), cardiac arrhythmias (OR 3.0, p = 0.015), deep vein thrombosis (OR 1.3, p = 0.045), and pulmonary embolism (OR 4.2, p < 0.001). However, no significant differences were observed in revision or RCR rates between groups.</div></div><div><h3>Conclusion</h3><div>Patients with RA undergoing shoulder arthroplasty face increased risks of postoperative complications compared to controls, highlighting the need for tailored perioperative strategies to optimize outcomes in this high-risk population.</div></div>\",\"PeriodicalId\":16633,\"journal\":{\"name\":\"Journal of orthopaedics\",\"volume\":\"69 \",\"pages\":\"Pages 96-100\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-03-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0972978X25000972\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X25000972","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

摘要

类风湿性关节炎（RA）是一种慢性自身免疫性疾病，以关节炎症、疼痛和僵硬为特征，常进展为关节糜烂和畸形。肩关节置换术是缓解RA患者严重关节炎疼痛的可靠治疗方法。本研究探讨了风湿性关节炎患者肩关节置换术的结果和并发症。方法使用PearlDiver国家保险索赔数据库进行回顾性队列研究，确定了2010年至2020年期间18岁以上接受初级肩关节置换术的患者，包括解剖、反向和半关节置换术。术前RA患者按年龄和性别与健康对照者1:2配对。主要结局包括翻修关节置换术和肩袖修复（RCR），而90天的并发症，如感染、伤口破裂和医疗状况是次要结局。采用多变量分析和卡方分析评估统计学显著性。结果33,282例患者中，11,431例（34.3%）术前有RA。RA组的90天并发症发生率明显更高，包括感染(OR 4.4, p <；0.001)，急诊科就诊(OR 3.0, p <；0.001)、心律失常（OR 3.0, p = 0.015）、深静脉血栓形成（OR 1.3, p = 0.045）和肺栓塞(OR 4.2, p <；0.001)。然而，两组间的修正率或RCR率没有显著差异。结论：与对照组相比，接受肩关节置换术的RA患者面临更高的术后并发症风险，这突出了需要定制围手术期策略来优化这一高危人群的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Outcomes and complications of shoulder arthroplasty in patients with rheumatoid arthritis: A large insurance claims matched cohort analysis

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation, pain, and stiffness, often progressing to joint erosion and deformity. Shoulder arthroplasty is a reliable treatment for alleviating severe arthritic pain in RA patients. This study examines the outcomes and complications of shoulder arthroplasty in individuals with RA.

Methods

A retrospective cohort study using the PearlDiver national insurance claims database identified patients over 18 who underwent primary shoulder arthroplasty, including anatomic, reverse, and hemiarthroplasty, between 2010 and 2020. Patients with preoperative RA were matched 1:2 with healthy controls by age and gender. Primary outcomes included revision arthroplasty and rotator cuff repair (RCR), while 90-day complications such as infections, wound disruption, and medical conditions were secondary outcomes. Statistical significance was assessed using multivariate and Chi-square analyses.

Results

Of 33,282 patients, 11,431 (34.3 %) had preoperative RA. The RA group exhibited significantly higher rates of 90-day complications, including infections (OR 4.4, p < 0.001), ED visits (OR 3.0, p < 0.001), cardiac arrhythmias (OR 3.0, p = 0.015), deep vein thrombosis (OR 1.3, p = 0.045), and pulmonary embolism (OR 4.2, p < 0.001). However, no significant differences were observed in revision or RCR rates between groups.

Conclusion

Patients with RA undergoing shoulder arthroplasty face increased risks of postoperative complications compared to controls, highlighting the need for tailored perioperative strategies to optimize outcomes in this high-risk population.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

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.