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10-Year Cumulative Incidence and Indications for Revision Total Knee Arthroplasty Among Patients Who Have Sickle Cell Disease.
Parel, Philip M; Kuyl, Emile-Victor; Agarwal, Amil R; Cohen, Jordan S; Gu, Alex; Harris, Andrew B; Ranson, Rachel A; Thakkar, Savyasachi C; Golladay, Gregory J.
Afiliación
  • Parel PM; Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
  • Kuyl EV; Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
  • Agarwal AR; Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia; Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Cohen JS; Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
  • Gu A; Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
  • Harris AB; Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Ranson RA; Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
  • Thakkar SC; Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Golladay GJ; Department of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
J Arthroplasty ; 38(9): 1748-1753.e1, 2023 09.
Article en En | MEDLINE | ID: mdl-37003459
ABSTRACT

BACKGROUND:

Literature regarding total knee arthroplasty (TKA) outcomes in sickle cell disease (SCD) is limited. Moreover, 10-year survivorship of SCD implants is unknown. This study aimed to observe 10-year cumulative incidence and indications for revision TKA in patients who did and did not have SCD.

METHODS:

Patients who underwent primary TKA were identified using a large national database. The SCD patients were matched by age, sex, and a comorbidity index to a control cohort in a 14 ratio. The 10-year cumulative incidence rates were determined using Kaplan-Meier survival analyses. Multivariable analyses were conducted using Cox proportional hazard modeling. Chi-squared analyses were conducted to compare indications for revision between cohorts. In total, 1,010 SCD patients were identified, 100,000 patients included in the unmatched control, and 4,020 patients included in the matched control.

RESULTS:

Compared to the unmatched control cohort, SCD patients exhibited higher 10-year all-cause revision (HR 1.86; P < .001) with higher proportions of revisions for periprosthetic joint infection (PJI) (P < .001), aseptic loosening (P < .001), and hematoma (P < .001). Compared to the matched control, SCD patients had higher 10-year all-cause revision (Hazard Ratio (HR) 1.39; P = .034) with a higher proportion of revisions for PJI (P = .044), aseptic loosening (P = .003), and hematoma (P = .019).

CONCLUSION:

Independent of other comorbidities, SCD patients are more likely to undergo revisions for PJI, aseptic loosening, and hematoma compared to patients who do not have SCD. Due to the high-risk of these complications, perioperative and postoperative surgical optimization should be enforced in SCD patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Infecciosa / Infecciones Relacionadas con Prótesis / Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2023 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Infecciosa / Infecciones Relacionadas con Prótesis / Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2023 Tipo del documento: Article