scholarly journals Acute Periprosthetic Infection After Total Knee Arthroplasty in Patients With Rheumatoid Arthritis Versus Osteoarthritis: a Population-based Study

2021 ◽  
Author(s):  
Ho-Ken Chung ◽  
Shu-Hui Wen ◽  
Wei-Chuan Chang ◽  
Kuan-Lin Liu
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Periprosthetic Infection ◽  
Population Based ◽  
Current Treatment ◽  
Research Database ◽  
Current Treatment Strategy ◽  
Total Knee ◽  
One Year

Abstract Osteoarthritis is the main cause for total knee arthroplasty, followed by rheumatoid arthritis. Previous studies have reported conflicting results concerning the risk of periprosthetic infection after total knee arthroplasty for rheumatoid arthritis and osteoarthritis patients. Thus, this study aimed to examine whether rheumatoid arthritis patients had a higher risk of acute periprosthetic infection after total knee arthroplasty compared to osteoarthritis patients. We conducted a retrospective cohort study using Taiwan’s National Health Insurance Research Database of the whole population from 2012 to 2015, and collected the medical records of osteoarthritis patients or rheumatoid arthritis patients who underwent total knee arthroplasty. To evaluate the risk of acute periprosthetic infection in rheumatoid arthritis patients, propensity score matching was implemented for osteoarthritis patients. Acute periprosthetic infection was observed in 2.58% of total knee arthroplasty cases in rheumatoid arthritis patients and 2.66% of total knee arthroplasty cases in osteoarthritis patients. Rheumatoid arthritis and osteoarthritis patients had comparable risk for 90-day and one-year periprosthetic infection. In conclusion, patients with rheumatoid arthritis were not at higher risk of acute periprosthetic infection after total knee arthroplasty compared to osteoarthritis patients. The current treatment strategy for patients with rheumatoid arthritis undergoing total knee arthroplasty is safe and appropriate.

scholarly journals Acute surgical site infection after total knee arthroplasty in patients with rheumatoid arthritis versus osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ho-Ken Chung ◽  
Shu-Hui Wen ◽  
Wei-Chuan Chang ◽  
Kuan-Lin Liu
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Confidence Interval ◽  
Surgical Site Infection ◽  
Knee Arthroplasty ◽  
Odds Ratio ◽  
Current Treatment ◽  
Research Database ◽  
Site Infection ◽  
Total Knee

AbstractOsteoarthritis is the main cause for total knee arthroplasty (TKA), followed by rheumatoid arthritis. Previous studies have reported conflicting results concerning the risk of surgical site infection after TKA for rheumatoid arthritis and osteoarthritis patients. Thus, this study aimed to examine whether rheumatoid arthritis patients had a higher risk of acute surgical site infection after TKA compared to osteoarthritis patients. We conducted a retrospective cohort study using Taiwan’s National Health Insurance Research Database of the whole population from 2012 to 2015, and collected the medical records of osteoarthritis patients or rheumatoid arthritis patients who underwent TKA. To evaluate the risk of acute surgical site infection in rheumatoid arthritis patients, propensity score matching was implemented for osteoarthritis patients. Acute surgical site infection was observed in 2.58% of TKA cases in rheumatoid arthritis patients and 2.66% of TKA cases in osteoarthritis patients. Rheumatoid arthritis and osteoarthritis patients had comparable risk for 90-day (odds ratio = 0.81, 95% confidence interval: 0.371–1.768) and 1-year (odds ratio = 0.463, 95% confidence interval: 0.121–1.766) surgical site infection. In conclusion, patients with rheumatoid arthritis were not at higher risk of acute surgical site infection after TKA compared to osteoarthritis patients. The current treatment strategy for patients with RA is safe and appropriate if they require TKA.

scholarly journals Rheumatoid Arthritis Flares After Total Hip and Total Knee Arthroplasty: Outcomes at One Year

2020 ◽  
Vol 72 (7) ◽  
pp. 925-932 ◽  
Author(s):  
Susan M. Goodman ◽  
Serene Z. Mirza ◽  
Edward F. DiCarlo ◽  
Diyu Pearce‐Fisher ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Total Knee ◽  
One Year

scholarly journals Pros and cons of navigated versus conventional total knee arthroplasty—a retrospective analysis of over 2400 patients

2021 ◽  
Author(s):  
Matthias Meyer ◽  
Tobias Renkawitz ◽  
Florian Völlner ◽  
Achim Benditz ◽  
Joachim Grifka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Analysis ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Complication Rates ◽  
Total Knee ◽  
One Year ◽  
Navigated Tka ◽  
Surgery Duration

Abstract Introduction Because of the ongoing discussion of imageless navigation in total knee arthroplasty (TKA), its advantages and disadvantages were evaluated in a large patient cohort. Methods This retrospective analysis included 2464 patients who had undergone TKA at a high-volume university arthroplasty center between 2012 and 2017. Navigated and conventional TKA were compared regarding postoperative mechanical axis, surgery duration, complication rates, one-year postoperative patient-reported outcome measures (PROMs) (WOMAC and EQ-5D indices), and responder rates as defined by the criteria of the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus (OMERACT-OARSI). Results Both navigated (1.8 ± 1.6°) and conventional TKA (2.1 ± 1.6°, p = 0.002) enabled the exact reconstruction of mechanical axis. Surgery duration was six minutes longer for navigated TKA than for conventional TKA (p < 0.001). Complication rates were low in both groups with comparable frequencies: neurological deficits (p = 0.39), joint infection (p = 0.42 and thromboembolic events (p = 0.03). Periprosthetic fractures occurred more frequently during conventional TKA (p = 0.001). One-year PROMs showed excellent improvement in both groups. The WOMAC index was statistically higher for navigated TKA than for conventional TKA (74.7 ± 19.0 vs. 71.7 ± 20.7, p = 0.014), but the increase was not clinically relevant. Both groups had a similarly high EQ-5D index (0.23 ± 0.24 vs. 0.26 ± 0.25, p = 0.11) and responder rate (86.5% [256/296] vs. 85.9% [981/1142], p = 0.92). Conclusion Both methods enable accurate postoperative leg alignment with low complication rates and equally successful PROMs and responder rates one year postoperatively. Level of evidence III. Retrospective cohort study.

scholarly journals A Population-Based Study of Trends in the Use of Total Hip and Total Knee Arthroplasty, 1969-2008

2010 ◽  
Vol 85 (10) ◽  
pp. 898-904 ◽  
Author(s):  
Jasvinder A. Singh ◽  
Michael B. Vessely ◽  
W. Scott Harmsen ◽  
Cathy D. Schleck ◽  
L. Joseph Melton ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Population Based ◽  
Population Based Study ◽  
Total Hip ◽  
Total Knee

Venous thromboembolism after total knee arthroplasty is associated with a worse functional outcome at one year

2021 ◽  
Vol 103-B (7) ◽  
pp. 1254-1260
Author(s):  
Lorenzo Calabro ◽  
Nick D. Clement ◽  
Deborah MacDonald ◽  
James T. Patton ◽  
Colin R. Howie ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Venous Thromboembolism ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Significant Independent Predictor ◽  
Total Knee ◽  
Five Dimension ◽  
One Year

Aims The primary aim of this study was to assess whether non-fatal postoperative venous thromboembolism (VTE) within six months of surgery influences the knee-specific functional outcome (Oxford Knee Score (OKS)) one year after total knee arthroplasty (TKA). Secondary aims were to assess whether non-fatal postoperative VTE influences generic health and patient satisfaction at this time. Methods A study of 2,393 TKAs was performed in 2,393 patients. Patient demographics, comorbidities, OKS, EuroQol five-dimension score (EQ-5D), and Forgotten Joint Score (FJS) were collected preoperatively and one year postoperatively. Overall patient satisfaction with their TKA was assessed at one year. Patients with VTE within six months of surgery were identified retrospectively and compared with those without. Results A total of 37 patients (1.5%) suffered a VTE and were significantly more likely to have associated comorbidities of stroke (p = 0.026), vascular disease (p = 0.026), and kidney disease (p = 0.026), but less likely to have diabetes (p = 0.046). In an unadjusted analysis, patients suffering a VTE had a significantly worse postoperative OKS (difference in mean (DIM) 4.8 (95% confidence interval (CI) 1.6 to 8.0); p = 0.004) and EQ-5D (DIM 0.146 (95% CI 0.059 to 0.233); p = 0.001) compared with patients without a VTE. After adjusting for confounding variables VTE remained a significant independent predictor associated with a worse postoperative OKS (DIM -5.4 (95% CI -8.4 to -2.4); p < 0.001), and EQ-5D score (DIM-0.169 (95% CI -0.251 to -0.087); p < 0.001). VTE was not independently associated with overall satisfaction after TKA (odds ratio 0.89 (95% CI 0.35 to 2.07); p = 0.717). Conclusion Patients who had a VTE within six months of their TKA had clinically significantly worse knee-specific outcome (OKS) and general health (EQ-5D) scores one year postoperatively, but the overall satisfaction with their TKA was similar to those patients who did not have a VTE. Cite this article: Bone Joint J 2021;103-B(7):1254–1260.

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