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10-Year Cumulative Incidence and Indications for Revision Total Knee Arthroplasty Among Patients Who Have Sickle Cell Disease.
- Source :
-
The Journal of arthroplasty [J Arthroplasty] 2023 Sep; Vol. 38 (9), pp. 1748-1753.e1. Date of Electronic Publication: 2023 Mar 31. - Publication Year :
- 2023
-
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.<br />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 1:4 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.<br />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).<br />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.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Incidence
Prosthesis Failure
Reoperation adverse effects
Retrospective Studies
Arthroplasty, Replacement, Knee adverse effects
Prosthesis-Related Infections epidemiology
Prosthesis-Related Infections etiology
Prosthesis-Related Infections surgery
Knee Prosthesis adverse effects
Arthritis, Infectious etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8406
- Volume :
- 38
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The Journal of arthroplasty
- Publication Type :
- Academic Journal
- Accession number :
- 37003459
- Full Text :
- https://doi.org/10.1016/j.arth.2023.03.070