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Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty

BACKGROUND: The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. METHODS: Patients re...

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Autores principales: Arias-de la Torre, Jorge, Smith, Kayla, Dregan, Alexandru, Valderas, Jose M., Evans, Jonathan P., Prieto-Alhambra, Daniel, Lozano, Luis, Molina, Antonio J., Martín, Vicente, Domingo, Laia, Muñoz, Laura, Espallargues, Mireia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346613/
https://www.ncbi.nlm.nih.gov/pubmed/32646395
http://dx.doi.org/10.1186/s12891-020-03455-3
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author Arias-de la Torre, Jorge
Smith, Kayla
Dregan, Alexandru
Valderas, Jose M.
Evans, Jonathan P.
Prieto-Alhambra, Daniel
Lozano, Luis
Molina, Antonio J.
Martín, Vicente
Domingo, Laia
Muñoz, Laura
Espallargues, Mireia
author_facet Arias-de la Torre, Jorge
Smith, Kayla
Dregan, Alexandru
Valderas, Jose M.
Evans, Jonathan P.
Prieto-Alhambra, Daniel
Lozano, Luis
Molina, Antonio J.
Martín, Vicente
Domingo, Laia
Muñoz, Laura
Espallargues, Mireia
author_sort Arias-de la Torre, Jorge
collection PubMed
description BACKGROUND: The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. METHODS: Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years’ follow-up was calculated, and adjusted Competing Risks models were fitted. RESULTS: A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses. CONCLUSIONS: Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA.
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spelling pubmed-73466132020-07-14 Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty Arias-de la Torre, Jorge Smith, Kayla Dregan, Alexandru Valderas, Jose M. Evans, Jonathan P. Prieto-Alhambra, Daniel Lozano, Luis Molina, Antonio J. Martín, Vicente Domingo, Laia Muñoz, Laura Espallargues, Mireia BMC Musculoskelet Disord Research Article BACKGROUND: The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. METHODS: Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years’ follow-up was calculated, and adjusted Competing Risks models were fitted. RESULTS: A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses. CONCLUSIONS: Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA. BioMed Central 2020-07-09 /pmc/articles/PMC7346613/ /pubmed/32646395 http://dx.doi.org/10.1186/s12891-020-03455-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Arias-de la Torre, Jorge
Smith, Kayla
Dregan, Alexandru
Valderas, Jose M.
Evans, Jonathan P.
Prieto-Alhambra, Daniel
Lozano, Luis
Molina, Antonio J.
Martín, Vicente
Domingo, Laia
Muñoz, Laura
Espallargues, Mireia
Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
title Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
title_full Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
title_fullStr Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
title_full_unstemmed Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
title_short Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
title_sort impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346613/
https://www.ncbi.nlm.nih.gov/pubmed/32646395
http://dx.doi.org/10.1186/s12891-020-03455-3
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