Impact of Metabolic Syndrome on Perioperative Complication Rates After Total Joint Arthroplasty Surgery

2014 ◽  
Vol 29 (9) ◽  
pp. 1842-1845 ◽  
Author(s):  
Mark J. Gage ◽  
Ran Schwarzkopf ◽  
Michael Abrouk ◽  
James D. Slover
Keyword(s):  
Metabolic Syndrome ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Complication Rates ◽  
Perioperative Complication ◽  
Arthroplasty Surgery

scholarly journals Coinfection of HIV and hepatitis C increases complication rates after total joint arthroplasty

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 37
Author(s):  
Christopher Fang ◽  
Ella Cornell ◽  
Quinten Dicken ◽  
David Freccero ◽  
David Mattingly ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Total Joint Arthroplasty ◽  
Complication Rate ◽  
Joint Arthroplasty ◽  
Complication Rates ◽  
Orthopaedic Care ◽  
History Of ◽  
Unique Outcome ◽  
Hcv Coinfection ◽  
Iv Drug Use

Introduction: As advances in efficacy of human immunodeficiency virus (HIV) and hepatitis-C virus (HCV) anti-viral medications increase, patients are able to maintain higher quality of lives than ever before. While these patients live longer lives, the unique patient population of those co-infected with both HIV and HCV increases. As these older patients seek orthopaedic care, it is important to understand their unique outcome profile. The purpose of this study was to evaluate the complication rate after total joint arthroplasty (TJA) in patients with HIV and HCV coinfection compared with patients with HIV or HCV only. Methods: A retrospective review of patients undergoing primary total joint arthroplasty (TJA) at our urban, academic hospital between April 2016 and April 2019 was conducted. Patients were stratified into three groups according to viral status: HIV only, HCV only, or HIV and HCV coinfection. Baseline demographics, intravenous drug (IV) use, surgery type, CD4+ count, follow-up and complications were analysed. Results: Of the 133 patients included in the study, 28 had HIV, 88 had HCV and 17 were coinfected with both HIV and HCV. Coinfected patients were more likely to have a lower BMI (p < 0.039) and a history of IV drug use (p < 0.018) compared to patients with either HIV or HCV only. Coinfected patients had a higher complication rate (41%) than both HIV only (7%; p < 0.001) and HCV only (12.5%; p < 0.001) patients. Discussion: Patients coinfected with HIV and HCV undergoing TJA have a higher complication rate than patients with either infection alone. As this unique population of coinfected patients continues to expand, increasingly they will be under the care of arthroplasty surgeons. Improved awareness and understanding of the baseline demographic differences between these patients is paramount. Recognition of the increased complication rates grants the opportunity to improve their orthopaedic care through preoperative and multidisciplinary management.

Quantifying Cardiovascular Risks in Patients With Metabolic Syndrome Undergoing Total Joint Arthroplasty

2012 ◽  
Vol 27 (4) ◽  
pp. 514-519 ◽  
Author(s):  
Kishor Gandhi ◽  
Eugene R. Viscusi ◽  
Eric S. Schwenk ◽  
Luis Pulido ◽  
Javad Parvizi
Keyword(s):  
Metabolic Syndrome ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Cardiovascular Risks

The Interaction of Obesity and Metabolic Syndrome in Determining Risk of Complication Following Total Joint Arthroplasty

2016 ◽  
Vol 31 (9) ◽  
pp. 192-196 ◽  
Author(s):  
Adam I. Edelstein ◽  
Linda I. Suleiman ◽  
Andrew P. Alvarez ◽  
Ryan M. Sacotte ◽  
Charles D. Qin ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

Bariatric Surgery and Time to Total Joint Arthroplasty: Does It Affect Readmission and Complication Rates?

2017 ◽  
Vol 28 (5) ◽  
pp. 1395-1401 ◽  
Author(s):  
Ran Schwarzkopf ◽  
Jessica A. Lavery ◽  
Jessica Hooper ◽  
Manish Parikh ◽  
Heather T. Gold
Keyword(s):  
Bariatric Surgery ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Complication Rates

Patients With Uncontrolled Components of Metabolic Syndrome Have Increased Risk of Complications Following Total Joint Arthroplasty

2013 ◽  
Vol 28 (6) ◽  
pp. 904-907 ◽  
Author(s):  
Benjamin Zmistowski ◽  
Ismar Dizdarevic ◽  
Christina L. Jacovides ◽  
Kris E. Radcliff ◽  
Boris Mraovic ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Increased Risk

scholarly journals The Potential Role of Ferritin in Relation to Inflammatory and Metabolic Syndrome Biomarkers in Patients Undergoing Total Joint Arthroplasty of the Hip or Knee

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4560-4560
Author(s):  
Christopher Wanderling ◽  
Jeffrey Liles ◽  
Peter Carlsgaard ◽  
Jennifer Saluk ◽  
Daneyal Syed ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Standard Deviation ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Iron Regulation ◽  
Healthy Controls ◽  
Plasma Samples ◽  
Blood Samples ◽  
C Peptide ◽  
Pai 1

Abstract Introduction: Maintaining proper iron regulation systemically is crucial in preserving systemic homeostasis. Ferritin is known to be a key component in this regulation by acting as a buffer via the controlled binding and releasing of iron. Ferritin is not only crucial in iron regulation, but it has also been observed to be a biomarker of inflammation. Considering this observation, it may be possible that ferritin plays a role in the pathogenesis of degenerative joint diseases (DJD). It has been identified that patients who had underwent total joint arthroplasty (TJA) procedure had increased serum levels of ferritin both pre-operatively and post-operatively. The rate of TJA procedures has been progressively increasing and it is projected that TJA procedures will increase to over 4 million procedures performed by 2030. In consideration of this observation, it is becoming increasingly important to gain a more comprehensive understanding in the pathology of DJD that require TJA procedure. The aim of this study is to examine the levels of ferritin in TJA patients pre-operatively and compare this level with those of other inflammatory and metabolic syndrome biomarkers in the patient samples while comparing the ferritin measurement to that of healthy controls. Study Design and Methods: After approval of the Institutional Review Board (IRB), pre-operative day one and post-operative day one blood samples of 45 TJA patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) procedure were obtained as de-identified samples. Blood samples were collected into tubes containing 3.2% (0.109M) sodium citrate, plasma was then isolated. Control citrated plasma samples from non-smoking, drug-free, volunteers (age 18-35 years old) were obtained from from a certified vendor (George King Biomedical, Overland Park, KS). Plasma samples were stored at -80O C. The plasma samples were profiled for ferritin, C-peptide, insulin, IL-6, resistin, IL-1a, and PAI-1 utilizing a biochip array technology (RANDOX, Antrim, UK). All individual results were compiled as mean+1 SD and are summarized in the following table. The Mann-Whitney U test and the Spearman correlation test were used to analyze patient and control samples. Results: Table. Normal Mean + standard deviation Pre-op Mean + standard deviation Post-op Mean + standard deviation Ferritin (ng/ml) 68.44±74.23 125.0±121.0 73.79±71.29 C-peptide (ng/ml) 3.22±2.577 2.65±2.986 3.40±3.64 IL-6 (pg/ml) 0.818±0.5228 27.18±41.18 55.69±38.74 Resistin (ng/ml) 2.49±0.7406 5.34±4.976 6.39±4.95 Insulin (uIU/ml) 20.77±19.01 37.75±82.58 41.39±77.53 IL-1a (pg/ml) 0.418±0.1507 0.663±0.7824 1.29±1.39 PAI-1 (ng/ml) 3.21±4.127 14.98±9.836 17.89±11.58 There were significant increases in pre-operative levels of ferritin (p=0.0305), IL-6 (p<0.0001), resistin, (p<0.0001), IL-1a (p=0.0483), and PAI-1 (p<0.0001). There were insignificant alterations in the levels of C-peptide (decreased) and insulin (increased) in the pre-operative samples when compared with the healthy controls. Pre-operative correlations were observed between ferritin and each of the measured biomarkers; C-peptide (p=0.0043, R=0.324), IL-6 (p=0.00034, R=0.40), resistin (p=0.00043 R=0.394), insulin (p=0.00054, R=0.388), IL-1a (p=0.0256, R=-0.256), and PAI-1 (p<0.0001, R=0.460). Post-operative correlations were observed between ferritin and C-peptide (p=0.0008, R=0.529), as well as Insulin (p=0.0037, R=0.372). There was a correlation observed between pre-operative and post-operative levels of ferritin (p=0.0035, R=0.4943). Interestingly, the post-op values for ferritin dramatically decreased despite an increase in all other inflammatory and metabolic biomarkers. Conclusions: Understanding the factors that may affect ferritin regulation in TJA patients may be helpful in the management of DJD. Profiling inflammatory and metabolic syndrome biomarkers, including ferritin, may provide dynamic management options in the future that not only reduce adverse outcomes in these patients but also control the progression of degenerative processes. Disclosures No relevant conflicts of interest to declare.

scholarly journals Outcomes of hip and knee total joint arthroplasty in a Canadian inmate population over a 10-year period

2018 ◽  
pp. 350-354
Author(s):  
Gavin Wood ◽  
Sebastien Lalonde ◽  
Kellen Walsh ◽  
Kelly Harper
Keyword(s):  
Total Joint Arthroplasty ◽  
Comparison Group ◽  
Demographic Data ◽  
Major Complication ◽  
Joint Arthroplasty ◽  
Complication Rates ◽  
Discharge Abstract Database ◽  
Inmate Population ◽  
Increased Risk ◽  
Perioperative Course

Background: Little information exists regarding the risk of complications in inmates who receive total hip or knee arthroplasties in Canada. Inmates tend to be less healthy owing to socioeconomic factors and an increased number of medical and psychiatric comorbidities. We compared revision and complication rates of total joint replacements in a cohort of incarcerated Canadians versus a cohort of non-inmates. Methods: We obtained a list of all Canadian inmate inpatient hospital visits with diagnostic/procedure codes of primary hip or knee arthroplasty within the last 10 years from our institution’s discharge abstract database. Demographic data and information related to the perioperative course, along with any data related to postoperative complications/readmissions, were obtained through manual chart review. Results: The inmate group consisted of 20 men (mean age 58 yr) with a total of 24 primary total joint arthroplasties; the comparison group included 171 men (mean age 62 yr). Postoperatively, the inmates had a 4-fold increased risk of major complication compared with non-inmates (33.3% v. 7.6%; odds ratio 4.21, p = 0.01). The inmates’ revision rate was 20.8% compared with 5.8% in the comparison group (p = 0.03). The most common cause for revision in the inmate group was infection, with a rate of 16.7% compared with 3.5% in the comparison group (p = 0.03). Conclusion: Patients requiring total joint arthroplasty who are inmates in the Canadian penitentiary system are at increased risk of complication and revision surgeries following total joint arthroplasty.

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