Rheumatoid Arthritis Versus Osteoarthritis in Patients Receiving Revision Total Knee Arthroplasty in the United States: Increased Perioperative Risks? A National Database-Based Propensity Score-Matching Study

作者：Pan, Xin; Wang, Jian; Shi, Zhe; Cheng, Hao; Lin, Zeming; Wu, Xuanping; Shi, Zhanjun^*

来源：JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2021, 29(23): E1176-E1183.

DOI：10.5435/JAAOS-D-20-00979

• TOTAL JOINT ARTHROPLASTY
• TOTAL HIP
• INFECTION
• COMPLICATIONS
• RATES

Background: The impacts of rheumatoid arthritis (RA) on perioperative risks among patients undergoing revision total knee arthroplasty (rTKA) have not been investigated yet. Thus, wehypothesized that patients with RA sustained increased perioperative risks and higher resource consumption burdens as compared to patients with osteoarthritis (OA) during the perioperative period. @@@ Patients and Methods: The National Inpatient Sample (NIS) database was used to compare the demographic characteristics, major inhospital complications, resource consumptions, and in-hospitalization mortality between patients with RA and OAafter rTKA. A 1:1 propensity score-matching, x(2) test, independence-sample T-test, and logistic regression analysis were done in statistical analyses to answer our hypotheses. @@@ Results: 4.3% (6363/132,405) of rTKA patients were diagnosed with RA. They tendedtobewomen andreceived revision for infectionbut with similar ages as compared to patients with OA. Except for acute postoperative anemia (oddsratio[OR]= 1.196), blood transfusion (OR = 1.179), prolonged hospitalization (OR = 1.049), and higher total cost (OR = 1.145), patients with RA sustained decreased odds of acute renal failure (OR = 0.804) and urinary complications (OR = 0.467). Besides, the other observed in-hospital complications showed no differences between patients with RA and OA. @@@ Conclusion: Despite consuming greater in-hospital resources, patients withRAdid not suffer increased odds of most in-hospital complications and in-hospital mortality for a revision TKA during the perioperative period. Compared with patients with OA, patients with RA sustained equivalent perioperative risks in the United States between 2002 and 2014.

• 单位
  1; 南方医科大学